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Systemic Immune-Inflammation Index Predicts Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary
Hangpan Jiang1, Duanbin Li2,3, Tian Xu2,3
1Department of Cardiology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, China.
Insights
The systemic immune-inflammation index (SII) is a significant predictor of contrast-induced acute kidney injury (CI-AKI). Higher SII levels are associated with an increased incidence of CI-AKI in patients undergoing coronary angiography.
Area of Science:
- Cardiology
- Nephrology
- Immunology
Background:
- The systemic immune-inflammation index (SII) is an emerging indicator correlated with cardiovascular diseases.
- Contrast-induced acute kidney injury (CI-AKI) is a significant concern in patients undergoing procedures involving intravascular contrast agents.
Purpose of the Study:
- To investigate the association between the systemic immune-inflammation index (SII) and the incidence of contrast-induced acute kidney injury (CI-AKI).
Main Methods:
- A retrospective cross-sectional study included 4,381 subjects undergoing coronary angiography (CAG).
- The systemic immune-inflammation index (SII) was calculated as neutrophil count × platelet count/lymphocyte count.
- Multivariable regression, ROC analysis, and structural equation modeling were employed to assess the relationship between SII and CI-AKI.
Main Results:
- 17.9% of patients developed CI-AKI post-contrast administration.
- Higher SII levels were linearly associated with increased serum creatinine elevation (β = 0.315, P < 0.001).
- Elevated SII demonstrated a significant association with increased CI-AKI incidence (OR = 2.914, P < 0.001) and showed a stronger direct effect than C-reactive protein.
Conclusions:
- The systemic immune-inflammation index (SII) is an independent predictor for CI-AKI in patients undergoing coronary angiography.
- SII has a good predictive value for CI-AKI, suggesting its utility in risk stratification.
Background And Aims:
Systemic immune-inflammation index (SII) is an emerging indicator and correlated to the incidence of cardiovascular diseases. This study aimed to explore the association between SII and contrast-induced acute kidney injury (CI-AKI).
Methods:
In this retrospective cross-sectional study, 4,381 subjects undergoing coronary angiography (CAG) were included. SII is defined as neutrophil count × platelet count/lymphocyte count. CI-AKI was determined by the elevation of serum creatinine (Scr). Multivariable linear and logistic regression analysis were used to determine the relationship of SII with Scr and CI-AKI, respectively. Receiver operator characteristic (ROC) analysis, structural equation model analysis, and subgroup analysis were also performed.
Results:
Overall, 786 (17.9%) patients suffered CI-AKI after the intravascular contrast administration. The subjects were 67.1 ± 10.8 years wold, with a mean SII of 5.72 × 1011/L. Multivariable linear regression analysis showed that SII linearly increased with the proportion of Scr elevation (β [95% confidence interval, CI] = 0.315 [0.206 to 0.424], P < 0.001). Multivariable logistic regression analysis demonstrated that higher SII was associated with an increased incidence of CI-AKI ([≥12 vs. <3 × 1011/L]: odds ratio, OR [95% CI] = 2.914 [2.121 to 4.003], P < 0.001). Subgroup analysis showed consistent results. ROC analysis identified a good predictive value of SII on CI-AKI (area under the ROC curve [95% CI]: 0.625 [0.602 to 0.647]). The structural equation model verified a more remarkable direct effect of SII (β = 0.102, P < 0.001) on CI-AKI compared to C-reactive protein (β = 0.070, P < 0.001).
Conclusions:
SII is an independent predictor for CI-AKI in patients undergoing CAG procedures.
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