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Predictive value of combining the level of fibrinogen and CHA2DS2-VASC Score for contrast-induced acute kidney injury in patients with acute coronary syndromes undergoing percutaneous coronary intervention

  • Nephrology - Original Paper
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Abstract

Objective

The present study aimed to investigate the value of preprocedural fibrinogen (FIB) combined with CHA2DS2-VASC scores in the risk prediction of contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI) in patients with acute coronary syndromes (ACS).

Method

A total of 934 patients (mean age 63.9 ± 11.5 years, and 32.1% female), who were admitted to our hospital for ACS and underwent PCI, were retrospectively enrolled. The patients were divided into two groups: non-CI-AKI group (n = 787) and CI-AKI group (n = 147). Contrast-induced acute kidney injury was defined as an increase of ≥ 0.5 mg/dL or ≥ 25% serum creatinine within 48–72 h after PCI. Spearman correlation analysis was used to determine the relationship between FIB and CHA2DS2-VASC scores.

Results

Patients with high baseline FIB levels and high CHA2DS2-VASC scores had higher CI-AKI incidence. On spearman correlation analysis, FIB and CHA2DS2-VASC scores were positively correlated (R = 0.236, P < 0.001). The ROC statistical analysis showed that the combination had 63.3% sensitivity with 72.6% specificity for the development of CI-AKI (area under the curve: 0.727, 95% CI 0.697–0.755, P < 0.001). A total of 934 ACS patients were divided into low-risk group (404 cases), medium-risk group (383 cases) and high-risk group (147 cases) according to the cut-off values of FIB and CHA2DS2-VASC scores. The incidence of CI-AKI was higher in the high-risk group than in the low-risk and medium-risk groups (Log-rank χ2 = 104.505, 56.647. P < 0.001). Multivariate analysis revealed that albumin (OR = 0.913, 95% CI 0.867–0.962), FIB (OR = 1.451, 95% CI 1.185–1.77), CHA2DS2-VASC score (OR = 1.271, 95% CI 1.504–1.78) were the independent risk factors of CI-AKI (p < 0.05).

Conclusion

The preprocedural fibrinogen combined with CHA2DS2-VASC score is independently associated with the risk of CI-AKI in ACS patients treated by PCI.

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Data availability

The data used to support the findings of this study can be obtained from the corresponding author.

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Author notes

  1. Jing Li and Zhen Wang contributed equally to this work.

Authors and Affiliations

  1. Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, 221000, China

    Jing Li, Zhen Wang & Wenhua Li

  2. Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China

    BaiXiang Zhang, Di Zheng, Yuan Lu & Wenhua Li

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  1. Jing Li
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Correspondence to Wenhua Li.

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Li, J., Wang, Z., Zhang, B. et al. Predictive value of combining the level of fibrinogen and CHA2DS2-VASC Score for contrast-induced acute kidney injury in patients with acute coronary syndromes undergoing percutaneous coronary intervention. Int Urol Nephrol 54, 2385–2392 (2022). https://doi.org/10.1007/s11255-022-03149-w

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