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Red blood cell distribution width-to-albumin ratio: a new inflammatory biomarker to predict contrast-induced nephropathy after emergency percutaneous coronary intervention

  • Nephrology - Original Paper
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Abstract

Purpose

Contrast-induced nephropathy (CIN) remains a dreaded complication in the cardiac diagnostic and interventional area. We investigated the relationship between red blood cell distribution width-to-albumin ratio (RAR) and CIN in elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI).

Methods

A total of 1532 elderly patients were enrolled and divided into the CIN group and the non-CIN group. The risk factors of CIN were evaluated by univariate and multivariate regression analysis. Receiver–operating characteristic (ROC) curve analysis was used to identify the best predictive value.

Results

CIN occurred in 129 (8.42%) patients. Patients in the CIN group had significantly higher RAR than those in the non-CIN group (4.69 ± 0.73 vs. 3.18 ± 0.64, P < 0.001). In multivariate regression analysis, RAR was an independent risk factor for the development of CIN (OR: 1.506, 95% CI: 1.227–2.083, P = 0.025), along with age, creatinine, eGFR, hs-CRP and contrast agent dose. The AUC of RAR was 0.755 (95% CI 0.703–0.807), and an optimal cutoff value of 3.64 or higher predicted CIN with a sensitivity of 76.2% and specificity of 65.7%.

Conclusion

As a combined inflammatory-related index, RAR was an independent risk factor for the development of CIN in elderly patients with STEMI undergoing emergency PCI. The RAR could be a simple but relatively reliable parameter for identifying high-risk patients.

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Authors and Affiliations

  1. Department of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, 100053, China

    Xipeng Sun, Zhenxing Fan, Zhi Liu, Jing Li & Qi Hua

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  1. Xipeng Sun
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Contributions

SXP drafted and revised the manuscript. HQ contributed to the conception of the work, conducting the study, and agreed on all aspects of the work. FZX, LZ and LJ assisted to collect and interpret the data. All authors have read and approved the final version of the manuscript.

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Correspondence to Qi Hua.

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Sun, X., Fan, Z., Liu, Z. et al. Red blood cell distribution width-to-albumin ratio: a new inflammatory biomarker to predict contrast-induced nephropathy after emergency percutaneous coronary intervention. Int Urol Nephrol 54, 3283–3290 (2022). https://doi.org/10.1007/s11255-022-03290-6

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