Related Experiment Video
Updated: May 29, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
High-sensitivity C-reactive protein predicts contrast-induced nephropathy after primary percutaneous coronary
Yong Liu1, Ning Tan, Ying-Ling Zhou
1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, PR China.
Insights
High-sensitivity C-reactive protein (hs-CRP) levels predict contrast-induced nephropathy (CIN) risk in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). Elevated hs-CRP significantly indicates higher CIN incidence and in-hospital death risk.
Area of Science:
- Cardiology
- Nephrology
- Biomarkers
Background:
- Contrast-induced nephropathy (CIN) is a complication following procedures using contrast media.
- Investigating novel biomarkers for CIN risk prediction is crucial, especially in acute myocardial infarction.
- High-sensitivity C-reactive protein (hs-CRP) has not been extensively studied as a CIN risk factor.
Purpose of the Study:
- To evaluate the predictive value of hs-CRP for CIN risk.
- To assess hs-CRP in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
Main Methods:
- Prospective observation of 165 STEMI patients undergoing primary PCI.
- CIN defined as serum creatinine increase >0.5 mg/dL within 48-72 hours post-contrast.
- Analysis of hs-CRP quartiles, receiver operator characteristic (ROC) curves, and multivariate logistic regression.
Main Results:
- CIN occurred in 10% of patients.
- CIN incidence significantly increased with hs-CRP quartiles (P-trend <0.001).
- An hs-CRP level of 16.10 mg/L was identified as a discriminator for CIN (OR=6.51, P<0.05) after adjustment.
Conclusions:
- Elevated hs-CRP (>16.10 mg/L) is a significant and independent predictor of CIN.
- hs-CRP may aid in identifying high-risk STEMI patients for CIN prevention strategies.
- This finding highlights the role of inflammation in CIN pathogenesis post-PCI.
Background:
Few studies have investigated hs-CRP as a risk factor for contrast-induced nephropathy (CIN). The aim of this study was to evaluate the predictive value of high-sensitivity C-reactive protein (hs-CRP) for risk of CIN in patients with acute ST-segment elevation myocardial infarction (STEMI) who were undergoing primary percutaneous coronary intervention (PCI).
Methods:
We prospectively observed 165 consenting patients with STEMI undergoing primary PCI. An increase in serum creatinine of more than 0.5 mg/dL from baseline within 48-72 hours of contrast media exposure was defined as CIN. Demographics, traditional risk factors, CIN incidence and other in-hospital clinical outcomes were compared among hs-CRP quartiles. Receiver operator characteristic curves were used to identify the optimal sensitivity for the observed range of hs-CRP. The predictive value of hs-CRP for the risk of CIN was assessed using multivariate logistic regression.
Results:
CIN occurred in 17 patients (10%). Univariate analysis revealed CIN incidence was significantly associated with hs-CRP, with 2.4% for quartile Q1 (<6.00 mg/L), 2.3% for Q2 (6.00-13.90), 12.5% for Q3 (13.91-32.75) and 24.4% for Q4 (>32.75) (P-trend <0.001), as was in-hospital death (0% for Q1, 2.3% for Q2, 5% for Q3 and 12.2% for Q4; P-trend = 0.009). Receiver operator characteristic curve analysis showed that an hs-CRP of 16.10 mg/L was a fair discriminator for the early creatinine increase (C statistic 0.78). After adjusting for potential confounding predictors, hs-CRP >16.10 mg/L remained significantly associated with CIN (odds ratio = 6.51; 95% confidence interval, 1.26-33.61).
Conclusion:
An hs-CRP >16.10 was a significant and independent predictor of CIN after primary PCI in patients with STEMI.
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT