Elevation of Preprocedural Systemic Immune Inflammation Level Increases the Risk of Contrast-Associated Acute Kidney Injury Following Coronary Angiography: A Multicenter Cohort Study

作者：Lai, Wenguang; Zhao, Xiaoli; Huang, Zhidong; Xie, Yun; Yu, Sijia; Tu, Jiabin; Guo, Dachuan; Xiu, Jiaming; Mai, Ziling; Li, Qiang; Huang, Haozhang; Li, Huanqiang; Xu, Jun-Yan; Lu, Hongyu; Chen, Guanzhong; Chen, Shiqun; Liu, Jin^*; Liu, Yong^*

来源：Journal of Inflammation Research, 2022, 15: 2959-2969.

DOI：10.2147/JIR.S364915

• systemic immune inflammation index
• contrast-associated acute kidney injury
• coronary angiography
• preprocedural

Background: Inflammation and immune responses play an important role in the pathophysiology of contrast-associated acute kidney injury (CA-AKI), and systemic immune inflammation index (SII) has recently emerged as a new parameter for immune and inflammatory response evaluation. However, limited research has been undertaken to explore the relationship between SII and CA-AKI following coronary angiography (CAG). Patients and Methods: From January 2007 to December 2020, 46,333 patients undergoing CAG were included from 5 Chinese tertiary hospitals. SII was calculated as total peripheral platelets count x neutrophil-to-lymphocyte ratio. Patients were categorized by preprocedural SII quartiles: Q1 <= 404.5, Q2 >404.5 and <= 631.7, Q3 >631.7 and <= 1082.8, Q4 >1082.8. Univariable and multivariable logistic regression were used to reveal the link between preprocedural SII and CA-AKI. Results: A total of the 46,333 patients (62.9 +/- 11.5 years, female 28.1%) were included in the study. The incidence of CA-AKI was 8.4% in Q1 group, 8.7% in Q2 group, 9.4% in Q3 group, 15.1% in Q4 group. In the multivariable model, comparing the highest (Q4 group) to lowest (Q1 group) SII level categories, preprocedural SII was related to a higher risk of CA-AKI after fully adjusting for well-known confounders, and there was no statistically difference in the other two SII level categories (Q2 and Q3 groups) compared with Q1 group (adjusted model 3: Q2 group: OR: 0.98, 95% CI: 0.87-1.11, P = 0.771; Q3 group: OR: 1.04, 95% CI: 0.92-1.18, P = 0.553; Q4: OR: 1.65, 95% CI: 1.45-1.88, p < 0.001; P for trend < 0.001). Similar results were found for all the subgroups analysis except for patients undergoing PCI, and the interaction analyses for age, PCI and AMI were significant. In addition, Kaplan-Meier curves demonstrated that the lowest quartile group showed the worst all-cause mortality in a significant SII level-dependent manner among the four groups (Log rank test; p < 0.0001). Conclusion: Elevated preprocedural SII level was a significant and independent risk factor for CA-AKI following CAG. Higher quality prospective studies are needed to validate the predictive value of SII for CA-AKI.

• 单位
  1; 广东省人民医院; 中山大学; 海南医学院; 广东省心血管病研究所; 南方医科大学; y