The Impact of Insulin Resistance on the Development of Post-PCI Contrast-Induced Nephropathy in Non-Diabetic STEMI

Contrast-induced nephropathy (CIN) is a condition characterized by rapidly decreasing renal funciton following by the application of contrast material. Precutaneous coronary intervention (PCI) is a life-saving treatment method that should be applied under emergent conditions. Unfortunately, the incidence of CIN after PCI is common. Patients with insulin resistance or diabetes have a greater risk of developing CIN than most of the population. Therefore, studies on the predictive effects of insulin resistance indicators on CIN are gaining momentum. One of the most popular indicators is triglyceride/glucose-body mass index (TyG-BMI). In this study we aimed to evaluate the effect of TyG-BMI index on CIN.

A total of 960 patinets who underwent emergency PCI due to ST elevation myocardial infarction (STEMI) between 2020 and 2023 were included in the study. Laboratory and demographic parameters were compared between the patients who did and did not develop CIN.

While CIN developed in 120 of the 980 patients included in the study, it did not develop in 860 patients. There were significant differences between the groups in terms of age (p < 0.001), gender (p = 0.005), presence of hypertension (p = 0.021), heart rate (p = 0.049), amount of contrast material (p < 0.001), left ventricular ejection fraction (p < 0.001), stent length (p = 0.022), SYNTAX score (p < 0.001), fasting plasma glucose (p < 0.001), baseline creatinine (p < 0.001), glomerular filtration rate (p < 0.001), uric acid (p < 0.001), C reactive protein (CRP) (p < 0.001), baseline creatin kinase myocard band (CKMB) (p = 0.019), CKMB peak (p = 0.030), triglyceride (p = 0.017), and TyG-BMI (p < 0.001). CRP, creatinine, uric asid, amount of contrast material, and TyG-BMI were independent predictors for the development of CIN.

TyG-BMI was a predictor of CIN in STEMI patient who underwent PCI under emergency conditions. In addition, the predicitive power of TyG-BMI was stronger than triglyceride-glucose index.