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De Ritis Ratio is Associated with Contrast-Associated Acute Kidney Injury Prediction and Long-Term Clinical Outcomes

Wenkang Zhang1,2, Mingkang Li2, Xu Huang2

  • 1Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China.

Angiology
|July 20, 2023
PubMed

Insights

The De Ritis ratio, a measure of liver enzymes, can predict contrast-associated acute kidney injury (CA-AKI) after emergency percutaneous coronary intervention (PCI). A higher ratio indicates increased risk for CA-AKI and adverse long-term outcomes.

Area of Science:

  • Cardiology
  • Nephrology
  • Biochemistry

Background:

  • Contrast-associated acute kidney injury (CA-AKI) is a significant complication after percutaneous coronary intervention (PCI).
  • Predictive biomarkers for CA-AKI and its long-term implications remain crucial for patient management.

Purpose of the Study:

  • To evaluate the predictive value of the De Ritis ratio for CA-AKI in patients undergoing emergency PCI.
  • To assess the association between the De Ritis ratio and long-term clinical outcomes in this patient cohort.

Main Methods:

  • A study included 546 patients undergoing emergency PCI.
  • The De Ritis ratio (AST/ALT) was calculated and analyzed for its correlation with CA-AKI incidence.
  • Long-term clinical outcomes were monitored, and the De Ritis ratio's independent predictive value was assessed using logistic and Cox regression models.

Main Results:

  • Patients who developed CA-AKI had significantly higher De Ritis ratios compared to those without CA-AKI (3.74 vs 1.61, P < .001).
  • The De Ritis ratio was an independent predictor of CA-AKI (OR, 2.243; P < .001) with an AUC of 0.813.
  • A high De Ritis ratio (≥1.76) was associated with a higher incidence of primary endpoints and predicted adverse long-term outcomes (HR, 1.888; P = .003).

Conclusions:

  • The De Ritis ratio serves as a valuable and independent predictor for contrast-associated acute kidney injury in patients undergoing emergency PCI.
  • Elevated De Ritis ratios are linked to adverse long-term clinical outcomes, highlighting its prognostic significance.
  • This ratio offers a practical tool for risk stratification and management of patients at risk for CA-AKI post-PCI.

Keywords:
De Ritis ratiocontrast-associated acute kidney injurypercutaneous coronary interventionprognosis

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