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Pan-Immune-Inflammation Value as a Novel Predictor of Contrast-Associated Acute Kidney Injury in Patients Treated

Gökhan Çiçek1, Sadık Kadri Açıkgöz1, Eser Açıkgöz2

  • 1Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, 06800 Ankara, Türkiye.

Journal of Clinical Medicine
|March 28, 2026
PubMed

Insights

The Pan-Immune-Inflammation Value (PIV) can predict contrast-associated acute kidney injury (CA-AKI) in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). Elevated PIV levels indicate a higher risk of developing CA-AKI after urgent PCI.

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarkers

Background:

  • Contrast-associated acute kidney injury (CA-AKI) is a significant complication following procedures requiring intravascular contrast agents.
  • Early identification of patients at high risk for CA-AKI is crucial, particularly for ST-segment elevation myocardial infarction (STEMI) patients undergoing urgent percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To evaluate the prognostic value of the Pan-Immune-Inflammation Value (PIV) in predicting CA-AKI.
  • To assess PIV as a biomarker in STEMI patients undergoing urgent PCI.

Main Methods:

  • Retrospective study of 2325 STEMI patients who underwent urgent PCI within 12 hours of symptom onset.
  • CA-AKI defined as a >25% or ≥0.5 mg/dL increase in serum creatinine within 48-72 hours post-procedure.
  • Analysis of admission PIV levels and their correlation with CA-AKI development using ROC and multivariate logistic regression.

Main Results:

  • Patients who developed CA-AKI had significantly higher PIV levels (502.5 ± 324.5 vs. 264.7 ± 165.8; p < 0.001).
  • A PIV cutoff value >320 demonstrated an AUC of 0.753 (95% CI: 0.740-0.787; p < 0.001), with 67% sensitivity and 66.9% specificity.
  • Elevated PIV (>320) was an independent predictor of CA-AKI (OR 2.118; 95% CI: 1.329-3.790; p < 0.001), along with age, Killip class, and contrast volume.

Conclusions:

  • Elevated admission PIV is a practical and independent biomarker for predicting CA-AKI in STEMI patients undergoing PCI.
  • PIV offers a valuable tool for risk stratification and potential early intervention in this high-risk patient population.

Keywords:
ST-segment elevation myocardial infarction (STEMI)cardiovascular diseasecontrast-associated acute kidney injurypan-immune-inflammation valueprimary percutaneous coronary intervention

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