Association of prealbumin levels with contrast-induced acute kidney injury in elderly patients with elective percutaneous coronary intervention.

Abstract

PURPOSE:

Inflammatory factors play a critical role in contrast-induced acute kidney injury (CI-AKI). Prealbumin, a nutritional and inflammatory indicator, is a well-established predictor of short- and long-term outcomes in numerous clinical conditions. The current study investigated the association of pre-procedural prealbumin levels with CI-AKI and long-term outcomes in geriatric patients after elective percutaneous coronary intervention (PCI).

PATIENTS AND METHODS:

A total of 558 patients aged≥75 years, who underwent elective PCI between January 2012 and December 2015, were selected for the current study. Pre-procedural prealbumin levels were measured before PCI. Multivariable logistic regression and Cox proportional hazard regression analyses were performed to identify the independent risk factors for CI-AKI and long-term mortality.

RESULTS:

Out of 558 patients, 54 developed CI-AKI. The optimal cutoff value of prealbumin for detecting CI-AKI was 185.5 mg/L with 62.7% sensitivity and 70.4% specificity based on the receiver operating characteristic analysis (C-statistic=0.710; 95% confidence interval [CI] 0.673-0.751). Multivariable analysis demonstrated that prealbumin≤185.5 mg/L was significantly associated with CI-AKI (odds ratio [OR] 0.397; 95% CI 0.195-0.808; P=0.011). Cox regression analysis demonstrated that prealbumin≤185.5 mg/L was associated with long-term mortality (adjusted hazard ratio [HR] 0.525; 95% CI 0.289-0.952; P=0.034) during the follow-up.

CONCLUSION:

Pre-procedural levels of prealbumin were independently associated with an increased risk of CI-AKI and long-term mortality in elderly patients undergoing elective PCI.

• Authors: Zhe-Bin You, Kai-Yang Lin, Wei-Ping Zheng, Chun-Jin Lin, Fan Lin, Tai-Lin Guo, Peng-Li Zhu, Yan-Song Guo
• Journal: Clinical interventions in aging (Clin Interv Aging) Vol. 13 Pg. 641-649 ( 2018) ISSN: 1178-1998 [Electronic] New Zealand
• PMID: 29713148 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• Peptide Fragments
• Prealbumin
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain

Topics

• Acute Kidney Injury (chemically induced, diagnosis, epidemiology, prevention & control)
• Aged
• Contrast Media (adverse effects)
• Elective Surgical Procedures
• Female
• Humans
• Long Term Adverse Effects (chemically induced, epidemiology, prevention & control)
• Male
• Natriuretic Peptide, Brain (analysis)
• Peptide Fragments (analysis)
• Percutaneous Coronary Intervention (adverse effects, methods)
• Postoperative Complications (diagnosis, epidemiology, prevention & control)
• Prealbumin (analysis)
• Predictive Value of Tests
• Reproducibility of Results
• Risk Factors