| Objective:In patients with ST-segment elevated myocardial infarction(STEMI)after corneal coronary intervention(PCI),the risk factors for contrast-induced acute kidney injury(CI-AKI)should be investigated.To evaluate the value of systemic immune-inflammatory index(SII)and Serum Uric Acid to Albumin Ratio(sUAR)in predicting CI-AKI.The predictive value of SII and sUAR combined with SII and sUAR alone in the incidence of CI-AKI after PCI in STEMI patients was compared.Methods:A total of 379 patients with STEMI who underwent PCI in the department of Cardiology of the North Jiangsu Hospital from January 2019 to September 2022 were randomly collected.A total of 308 enrolled patients were screened in the light of the exclusion criteria.All enrolled patients were sampled for venous blood test before surgery,and the hospital case system was queried to record clinical data of them,including gender,age,blood pressure,heart rate,past history,smoking history,laboratory data,imaging data,drugs used in hospital,coronary angiography endings,etc.SII and sUAR was confirmed in the light of preoperative blood routine and renal function examination results.According to the preoperative and postoperative serum creatinine(Scr),the occurrence of CI-AKI in the enrolled patients was determined.Depending on the incidence of CI-AKI,the enrolled patients were divided into the group with and without CI-AKI.The data of the two groups of patients were compared,including general data,imaging data and laboratory data.Logistic regression analysis was used to identify risk factors for CI-AKI.We used the receiver operating characteristic curve(ROC)to count the optimal cut-off values for sUAR and SII to forecast the occurrence of CI-AKI.The predictive impression of SII,sUAR and their combination in predicting CI-AKI was analyzed by ROC.Divide patients into two groups on the basis of the optimal threshold for SII:high SII group and low SII group.Divide patients into two groups on the basis of the optimal threshold for SII:high sUAR group and low sUAR group.SII and sUAR can represent the level of inflammation in the body.On the basis of the optimal cut-off values of SII and sUAR,SII and sUAR indexes were combined in pairs and sufferers were grouped into three teams.High inflammation group(high SII and high sUAR),moderate inflammation group(high SII and low sUAR or low SII and high sUAR),low inflammation group(low SII and low sUAR).The overall CI-AKI index between the three groups has been statistically analysed.This article uses SPSS26 software for statistical analysis and P<0.05 shows statistical value.Result:1.A total of 308 suffers participated in this study,including 79 patients with CI-AKI and 229 patients without CI-AKI.There were significant differences in Killip classification Ⅱ-Ⅳ,leukocyte count,neutrophil count,lymphocyte count,platelet count,serum albumin,serum uric acid,total cholesterol,low density lipoprotein,amino terminal peptide,SII,sUAR and preoperative baseline serum creatinine(P<0.05).2.Identification of risk factors for CI-AKI in patients using logistic regression analysis.The results showed that SII and sUAR were risk factors for CI-AKI after PCI in STEMI patients.3.ROC analysis results showed that the Area under the curve(AUC)of SII predicted CI-AKI was 0.923(95%CI:0.891-0.955,P<0.001),the best cut-off value was 963.15,the sensitivity was 82.3%,and the specificity was 86.0%.By optimal equation,they are divided into two groups:high and low.Comparison between two groups shows that the incidence rate of CI-AKI in the high SII group is significantly higher than in the low SII group,with a statistically significant difference(P<0.05).4.The ROC analysis results showed that the AUC for predicting CI-AKI by sUAR was 0.897(95%CI:0.860-0.934,P<0.001),the best cutoff value was 8.67,the sensitivity was 87.3%,and the specificity was 74.7%.Based on the optimal cutoff value,the patients were divided into two groups.The results announced that the incidence of CI-AKI in the high group was significantly higher than that in the low group,with a statistically significant difference(P<0.05)5.According to ROC analysis,the AUC of SII combined with sUAR for CI-AKI after PCI was 0.972(95%CI:0.955-0.989,P<0.001).The data from this study calculated a sensitivity of 94.9%and a specificity of 87.3%.The results showed that SII combined with sUAR could further improve the predictive value of CI-AKI after PCI in STEMI patients.6.Compared with the high inflammation group,the total incidence of CI-AKI was lower in the moderate inflammation group and the low inflammation group,with a statistically significant difference(P<0.001). |
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