AIM To explore the prognostic value of C-reactive protein/plasma prealbumin ratio (CP ratio) in predicting renal insufficiency complicated with acute myocardial infarction.
METHODS This study was a single-center, observational and retrospective cohort study. The subjects of the study were moderate and severe chronic kidney disease (CKD, the estimated glomerular filtration rate eGFR was between (15～60) ml/(min/1.73 m2) patients with ST-segment elevation myocardial infarction (STEMI) who underwent coronary angiography in the Department of Cardiology of our hospital from January 2020 to March 2023. The CP ratio was obtained by dividing serum CRP by serum prealbumin level and the main outcome of the study was acute renal injury (AKI).
RESULTS Compared with the group without AKI, patients in the AKI group had older age (P<0.01), higher white blood cell counts (P<0.05), higher levels of troponin (P<0.01), higher levels of creatine kinase isoenzymes (CK-MB) (P<0.01), lower baseline eGFR (P<0.05), higher CRP (P<0.01), higher CP ratio (P<0.01), higher proportion of multi vessel diseases (P<0.05), and a larger total amount of contrast agent used (P<0.01), The proportion of PCI surgery is high (P<0.01), and the proportion of coronary artery bypass grafting is low (P<0.01). Multivariate logistic regression analysis showed that age (OR=1.04; 95% CI=1.02～1.08; P=0.006), eGFR (OR=0.97; 95% CI=0.95～0.99; P=0.03), contrast agent volume (OR=1.01; 95% CI=1.00～1.01; P=0.01), and CP ratio (OR=1.36; 95% CI=1.17～1.57; P=0.004) were important predictors of AKI. In ROC curve analysis, the area under the curve predicted by CP ratio for AKI is 0.732, and the optimal cutoff point is 0.46 (sensitivity: 69.1%; specificity: 78.2%; P<0.01).
CONCLUSION The increase of CP ratio before operation is related to AKI in patients with moderate and severe CKD undergoing PCI.
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