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Inflammatory Prognostic Index May Predict the Development of Contrast-Induced Nephropathy in Patients with ST-Segment
Yusuf Can1, Emre Eynel2, Şevval Özdemir2
1Department of Cardiology, Sakarya University School of Medicine, Turkey.
The inflammatory prognostic index (IPI) effectively predicts contrast-induced nephropathy (CIN) in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). IPI shows superior performance over other inflammation markers for CIN risk assessment.
Area of Science:
- Cardiology
- Nephrology
- Inflammation markers
Background:
- Contrast-induced nephropathy (CIN) is a significant complication in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI).
- Predictive models for CIN are crucial for timely intervention and improved patient outcomes.
- Inflammation-based indices are increasingly recognized for their prognostic value in cardiovascular diseases.
Purpose of the Study:
- To evaluate the predictive performance of inflammation-based indices for CIN development in STEMI patients undergoing pPCI.
- To specifically assess the utility of the inflammatory prognostic index (IPI) in predicting CIN.
- To compare the discriminative performance of IPI against other established inflammation markers.
Main Methods:
- Retrospective analysis of 563 STEMI patients undergoing pPCI.
- Calculation and comparison of admission inflammation-based indices: IPI, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein-to-albumin ratio (CAR), and systemic immune inflammation index (SII).
- Multivariate logistic regression and receiver operating characteristic (ROC) curve analysis to determine independent predictors and discriminative performance.
Main Results:
- CIN developed in 15.1% of patients.
- Admission IPI was significantly higher in patients who developed CIN (10.9 vs 4.8, P < .001).
- IPI independently predicted CIN (OR 1.31, P = .013) and demonstrated superior discriminative performance (AUC 0.826) compared to NLR (AUC 0.691), CAR (AUC 0.712), and SII (AUC 0.704).
- An IPI cutoff of 8.35 predicted CIN with 82.4% sensitivity and 65.9% specificity.
Conclusions:
- The inflammatory prognostic index (IPI) is a superior predictor of contrast-induced nephropathy (CIN) in STEMI patients undergoing pPCI.
- IPI offers better discriminative ability for CIN risk compared to NLR, CAR, and SII.
- Utilizing IPI may aid in identifying high-risk patients for CIN and guiding preventative strategies.
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