Key result
Higher Remnant Cholesterol Inflammatory Index linked to ~3% higher contrast nephropathy risk after primary PCI.
Why the study?
Contrast-induced acute kidney injury remains a clinically important complication after PCI in STEMI patients, and the association of the remnant cholesterol inflammatory index with CI-AKI is unclear.
Does elevated Remnant Cholesterol Inflammatory Index (RCII) predict an increased risk of contrast-induced acute kidney injury in STEMI patients undergoing primary PCI?
Observational (n=771)
No
Does elevated Remnant Cholesterol Inflammatory Index (RCII) predict an increased risk of contrast-induced acute kidney injury in STEMI patients undergoing primary PCI?
Odds Ratio: 1.026 (95% CI 1.007–1.045)
Absolute Event Rate: 15.32% vs 6.74%
p-value: p=0.007
Retrospective observational study shows elevated remnant cholesterol inflammatory index independently increases contrast-induced acute kidney injury risk in STEMI, suggesting value for risk...
Background: Contrast-induced acute kidney injury (CI-AKI) remains a clinically important complication after percutaneous coronary intervention (PCI), particularly in patients with ST-segment elevation myocardial infarction (STEMI). The remnant cholesterol inflammatory index (RCII), integrating remnant cholesterol (RC) and C-reactive protein (CRP), may reflect both residual lipid burden and systemic inflammatory activation. This study aimed to evaluate the association between RCII and CI-AKI in patients with STEMI undergoing PCI. Methods: This single-center retrospective observational study included 771 consecutive patients with STEMI who underwent primary PCI between May 2023 and May 2026. The primary outcome was in-hospital CI-AKI. Multivariable logistic regression, restricted cubic spline (RCS) analysis, receiver operating characteristic (ROC) analysis, integrated discrimination improvement (IDI), and continuous net reclassification improvement (NRI) were performed. Results: CI-AKI occurred in 85 patients (11.0%). Patients with high RCII had a significantly higher incidence of CI-AKI than those with low RCII (15.32% vs 6.74%, P<0.001). In multivariable logistic regression analysis, RCII remained independently associated with CI-AKI after adjustment for relevant covariates (adjusted odds ratio=1.026, 95% confidence interval: 1.007-1.045, P=0.007). RCS analysis demonstrated a significant nonlinear dose-response relationship between RCII and CI-AKI. The addition of RCII to the baseline clinical model resulted in significant improvements in IDI (0.027, P=0.015) and continuous NRI (0.283, P=0.007), whereas the increase in AUC was modest and not statistically significant. Conclusion: Elevated RCII was independently associated with an increased risk of CI-AKI in patients with STEMI undergoing PCI. RCII may serve as a simple and readily available biomarker to assist in risk stratification.
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Li et al. (2026) conducted an observational in ST-Segment Elevation Myocardial Infarction (STEMI) undergoing primary PCI (n=771). Remnant Cholesterol Inflammatory Index (RCII) vs. Low RCII was evaluated on In-hospital contrast-induced acute kidney injury (CI-AKI) (OR 1.026, 95% CI 1.007-1.045, p=0.007). Elevated Remnant Cholesterol Inflammatory Index was independently associated with increased risk of contrast-induced acute kidney injury (adjusted OR 1.026) after primary PCI in STEMI patients.
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