Inflammatory markers of contrast-induced nephropathy in patients with acute coronary syndrome

Coron Artery Dis. 2020 May;31(3):279-283. doi: 10.1097/MCA.0000000000000823.

Abstract

Objective: Contrast-induced nephropathy (CIN) is among the serious complications of invasive cardiovascular procedures that are performed with the administration of contrast agents. We investigated the role of the inflammatory markers in predicting CIN in acute coronary syndrome patients.

Methods: This study included 232 consecutive patients with acute coronary syndrome who underwent emergency angiography at our center.

Results: There were 38 (19.1%) patients in the CIN group (mean age: 62.4 ± 10.2; 68.4% male), and 162 patients in the non-CIN group (mean age: 62.1 ± 11.5; 60.5% male). In the CIN positive group, serum gamma-glutamyl transferase (GGT) (P < 0.001), uric acid (P < 0.001), high sensitivity C-reactive protein (P < 0.001), the neutrophil-to-lymphocyte ratio (P = 0.02) were higher, whereas vitamin D (P < 0.001), hemoglobin (P < 0.001) and baseline glomerular filtration rate (P = 0.011) were lower compared with the CIN negative group. The receiver operating characteristic analysis showed that the cutoff point of GGT was 56 U/L for predicting CIN with a 84.2% sensitivity and a 72.2% specificity (area under the curve = 0.879, P < 0.001). The predictive value of GGT was the highest compared other inflammatory markers for CIN (area under the curve = 0.879).

Conclusion: Our study showed that the levels of GGT, high sensitivity C-reactive protein, vitamin D, uric acid and neutrophil-to-lymphocyte ratio were the effective factors in development of CIN. The level of GGT was found as the most effective factor in prediction of the development of CIN.

MeSH terms

  • Acute Coronary Syndrome / diagnostic imaging*
  • Acute Kidney Injury / blood
  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / metabolism*
  • Aged
  • C-Reactive Protein / metabolism*
  • Contrast Media / adverse effects*
  • Coronary Angiography
  • Female
  • Glomerular Filtration Rate
  • Hemoglobins / metabolism
  • Humans
  • Inflammation / blood
  • Inflammation / metabolism
  • Leukocyte Count
  • Lymphocyte Count
  • Lymphocytes*
  • Male
  • Middle Aged
  • Neutrophils*
  • ROC Curve
  • Risk Assessment
  • Uric Acid / metabolism*
  • Vitamin D / metabolism
  • gamma-Glutamyltransferase / metabolism*

Substances

  • Contrast Media
  • Hemoglobins
  • Vitamin D
  • Uric Acid
  • C-Reactive Protein
  • gamma-Glutamyltransferase