Preprocedural SII Combined with High-Sensitivity C-Reactive Protein Predicts the Risk of Contrast-Induced Acute Kidney Injury in STEMI Patients Undergoing Percutaneous Coronary Intervention

Abstract

Objective To investigate the relationship between the incidence of contrast-induced acute kidney injury (CI-AKI) and the levels of the systemic immune-inflammatory index (SII, platelet × neutrophil/lymphocyte ratio) and high-sensitivity C-reactive protein (hsCRP) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI), to analyze further the predictive value of the combination of SII and hsCRP for CI-AKI. Methods Retrospectively analyze the clinical data of STEMI patients who underwent PCI in our cardiology department from November 2019 to March 2021. Restricted cubic splines were used to determine the correlation between SII and hsCRP and the risk of CI-AKI. Patients were divided into the CI-AKI group (n=71) and the non-CI-AKI group (n=344) according to postoperative creatinine changes. Logistic regression was used to analyze the factors influencing CI-AKI. ROC curves were used to evaluate the predictive value of SII, hsCRP, and their combined levels on CI-AKI. Results Restricted cubic spline analysis showed that when SII>653.73×10 9 /L and hsCRP>5.52mg/dl, there was a positive correlation with the incidence of CI-AKI. And the incidence of CI-AKI rose with the inflammation status. The receiver operating characteristic curve of SII combined with hsCRP was 0.831, which was higher than SII or hsCRP alone. The logistic regression analysis showed that high-risk factors of CI-AKI were diabetes mellitus, platelet count, and highly elevated SII and hsCRP. Conclusion Within a certain range, elevated inflammatory biomarkers SII and hsCRP were risk factors for CI-AKI after PCI in patients with STEMI. This study suggests that the combination of SII and hsCRP predicts the risk of CI-AKI more accurately than either biomarker alone.

What Promotes Acute Kidney Injury in Patients with Myocardial Infarction and Multivessel Coronary Artery Disease—Contrast Media, Hydration Status or Something Else?

“…An analysis of 11 studies showed a moderate diagnostic value of IL-18 [ 71 ]. Other inflammatory markers such as the systemic immune-inflammatory response index (SII) and high-sensitivity C-reactive protein (hsCRP) may also prove useful [ 72 , 73 ]. These new biomarkers can aid risk stratification, early detection and early intervention in case of AKI in patients with AMI.…”

Activities of Daily Living Predict Contrast-Associated Acute Kidney Injury among Population Undergoing Coronary Angiography

“…Lian et al also supported that the decline in ADL resulted in the upregulation of inflammatory markers [35] . Inflammatory markers upregulation, involving C-Reactive Protein (CRP), etc., is closely related to the occurrence of CA-AKI [36,37] . In the current research, the predictive value of BI score on the occurrence of CA-AKI was still observed after adjustment for these well-established risk factors.…”

Systemic Immune-Inflammation Index (SII) as a Predictor of Short-Term Mortality Risk in Sepsis-Associated Acute Kidney Injury: A Retrospective Cohort Study

“…The literature contains little information on the relationship between the SII and short-term mortality in SA-AKI [25]. Academic efforts have primarily focused on the prognostic potential of SII in disease onset prediction [11,26,27]. Studies indicate higher SII levels among SA-AKI cohorts compared to non-AKI groups.…”