Key result
Elevated C-reactive protein to albumin ratio linked to ~34% higher contrast nephropathy risk after PCI.
Why the study?
Does the peak C-reactive protein to lower albumin ratio (CAR) predict the development of contrast-induced acute kidney injury (CI-AKI) in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention?
Cohort (n=210)
No
Does the peak C-reactive protein to lower albumin ratio (CAR) predict the development of contrast-induced acute kidney injury (CI-AKI) in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention?
An elevated C-reactive protein to albumin ratio (CAR) post-pPCI is an independent, easily accessible biomarker that predicts contrast-induced acute kidney injury better than CRP or albumin alone in AMI patients.
Aim: The present study aims to investigate the predictive value of the peak C-reactive protein to reduced albumin ratio (CAR) in the development of contrast-induced acute kidney injury (CI-AKI) in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (pPCI).Material and Method: Two hundred and ten patients with non-ST and ST-elevation AMI undergoing pPCI were recorded.Renal function parameters and highest CAO values of the patients after pPCI were recorded from the patient files.The patient population was divided intothe low-, mid-, and high-CAR tertiles (all n=70) after their CAR values were ranked from least to greatest.Results: Eighty-nine (42.38%) patients developed CI-AKI.The absolute increase in serum creatinine (sCr) was significantly higher in patients in the high-CAR tertile (0.31, interquartile range (IQR): 1.925-0.555)than in the low-CAR (0.2, IQR: 0.118-0.27)and mid-CAR tertiles (0.2, IQR: 0.13-0.33;p<0.001).The area under the curve of CAR was0.689(95% CI: 0.614-0.763;p<0.001) in the receiver operating characteristic analysis.After adjusting for other risk factors of CI-AKI, CAR remained predictors of the development of CI-AKI (OR: 1.345, 95% CI: 1.009-1.794,p=0.043). Conclusion:The elevated CAR value is independent predictors in the development of CI-AKI in patients with AMI undergoing pPCI.In this patient group, the elevated CAR value after pPKG may alert us to more improve CI-AKI.
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Ahmet Karakurt (2021) conducted a cohort in Acute myocardial infarction (NSTEMI and STEMI) undergoing primary percutaneous coronary intervention (n=210). Peak C-reactive protein to lower albumin ratio (CAR) vs. Lower CAR levels / tertiles (low-CAR ≤0.415, mid-CAR >0.415 to ≤1.076 vs high-CAR >1.076) was evaluated on Contrast-induced acute kidney injury (CI-AKI), defined as an absolute increase of ≥0.5 mg/dl (44 µmol/L) or ≥25% in basal serum creatinine within 24-72 hours after contrast exposure (OR 1.345, 95% CI 1.009-1.794, p=0.043). Elevated peak C-reactive protein to albumin ratio independently predicted contrast-induced acute kidney injury (OR 1.345, 95% CI 1.009-1.794, p=0.043; AUC 0.689) in AMI patients undergoing primary PCI.
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