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Updated: Jun 22, 2025

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Published on: April 18, 2013
Association between Pan-Immune-Inflammation Value and Contrast-Induced Nephropathy with Coronary Angiography
Suleyman Akkaya1, Umit Cakmak2
1Department of Cardiology, Health Sciences University, Gazi Yasargil Research and Training Hospital, 21100 Diyarbakir, Turkey.
Insights
The pan-immune-inflammation value (PIV) may predict contrast-induced nephropathy (CIN) risk after coronary angiography. Higher PIV levels and older age were associated with increased CIN risk in patients undergoing cardiovascular procedures.
Area of Science:
- Cardiology
- Nephrology
- Inflammation Biomarkers
Background:
- Contrast-induced nephropathy (CIN) is a significant complication post-cardiovascular procedures.
- Inflammation plays a key role in CIN development.
- Peripheral blood-based indexes offer potential as accessible CIN biomarkers.
Purpose of the Study:
- To investigate the association between the pan-immune-inflammation value (PIV) and CIN risk.
- To evaluate PIV as a predictive biomarker for CIN following coronary angiography.
Main Methods:
- A cohort of 1343 patients undergoing coronary angiography (CAG) was analyzed.
- Pan-immune-inflammation value (PIV) calculated as (neutrophil count × platelet count × monocyte count)/lymphocyte count.
- Multivariable regression analyses identified predictors of CIN.
Main Results:
- Contrast-induced nephropathy (CIN) developed in 15% of patients.
- Higher PIV levels (OR: 1.016) and older age (OR: 1.015) were significantly associated with increased CIN risk.
- Antiplatelet agent use correlated with a reduced risk of CIN (OR: 0.670).
Conclusions:
- Elevated PIV levels and advanced age are significant risk factors for CIN in patients undergoing CAG.
- PIV may serve as a minimally invasive biomarker for predicting CIN risk.
- Further prospective studies are warranted to confirm PIV's predictive utility.
Abstract:
Background: Contrast-induced nephropathy (CIN) is one of the most important complications after invasive cardiovascular procedures. Considering the pivotal role of inflammation in CIN development, the use of peripheral blood-based indexes may be an easily available biomarker to predict CIN risk. Therefore, in the present study, we evaluated the association between the pan-immune-inflammation value (PIV) and the risk of CIN. Patients and Methods: A total of 1343 patients undergoing coronary angiography (CAG) were included. The PIV was calculated with the following equation: (neutrophil count × platelet count × monocyte count)/lymphocyte count. Multivariable regression analyses were used to determine the association between clinical and laboratory parameters and CIN development. Results: The median age of the cohort was 58 (IQR 50-67), and 48.2% of the patients were female. CIN developed in 202 patients (15%) in follow-up. In multivariate analyses, older age (OR: 1.015, 95% CI: 1.002-1.028, p = 0.020) and higher PIV levels (OR: 1.016, 95% CI: 1.004-1.028, p = 0.008) were associated with a higher CIN risk, while the use of antiplatelet agents was associated with a lower risk of CIN (OR: 0.670, 95% CI: 0.475-0.945, p = 0.022). Conclusions: We demonstrated that the risk of CIN was significantly higher in patients with higher PIV and older patients in a large cohort of patients undergoing CAG for stable ischemic heart disease. If supported with prospective evidence, PIV levels could be used as a minimally invasive reflector of CIN.
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