Affiliation:
1. Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou China
2. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou China
3. Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou China
4. Interventional Center of Valvular Heart Disease Beijing Anzhen Hospital, Capital Medical University Beijing China
Abstract
AbstractAimCardiac biomarkers' predictive value of contrast‐associated acute kidney injury (CA‐AKI) remains unclear. We analysed whether creatine kinase isoenzyme‐MB (CKMB), cardiac troponin I (cTnI) and preoperative N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) are tied to CA‐AKI patients undergoing cardiac catheterization.MethodsIn the multi‐center study, we included 3553 people underwent cardiac catheterization for analysis. CA‐AKI was defined as the absolute increase of over 0.3 mg/dL or an increase of more than 50% compared with the baseline serum creatinine within 48 hours following cardiac catheterization. Logistic regression model and receiver operating characteristic (ROC) curves were used to examine the association between cardiac biomarkers and CA‐AKI and the efficacy of Mehran risk score (MRS) model on CA‐AKI prediction with and without cardiac biomarkers.ResultsAmong 3553 people, 200 people eventually developed CA‐AKI. The logistic regression model showed that log10CKMB (odds ratio (OR): 1.97, 95%CI:1.51–2.57, p < .001), cTnI (OR: 1.03, 95%CI: 1.02–1.04, p < .001) and log10NT‐proBNP (OR: 3.19, 95%CI: 2.46–4.17, p < .001) were independent predictors of CA‐AKI. The ROC curve demonstrated that area under the curve (AUC) of MRS was 0.733. CKMB, cTnI and NT‐proBNP all significantly improved the AUC value in combination with MRS model. (NT‐proBNP: 0.798, p < .001; CKMB: 0.758, p = .003; cTnI: 0.755, p = .002), among which the NT‐proBNP had the best predictive efficacy improvement.ConclusionCardiac biomarkers of CKMB, cTnI and NT‐proBNP are all independently associated with CA‐AKI among patients undergoing cardiac catheterization while NT‐proBNP remains the best indicator. Adding CKMB, cTnI and NT‐proBNP to MRS improved the prognostic efficacy and may be considered effective tools to predict the risk of CA‐AKI in clinical practice.
Subject
Nephrology,General Medicine