The association between systemic inflammatory response index and contrast-associated acute kidney injury in patients undergoing elective percutaneous coronary intervention

Abstract

Background

The systemic inflammatory response index (SIRI), served as a novel inflammatory biomarker, is the synthesis of neutrophils, monocytes and lymphocytes.

Aims

We hypothesized that SIRI has predictive value for contrast-associated acute kidney injury (CA-AKI) and long-term mortality in patients undergoing elective percutaneous coronary intervention (PCI).

Methods

We retrospectively observed 5685 patients undergoing elective PCI from January 2012 to December 2018. Venous blood samples were collected to obtain the experimental data on the day of admission or the morning of the next day. SIRI = neutrophil count × monocyte count/lymphocyte count. CA-AKI was defined as an increase of 50% or 0.3 mg/dl in SCr from baseline within 48 h after contrast exposure.

Results

The incidence of CA-AKI was 6.1% (n = 352). The best cutoff value of SIRI for predicting CA-AKI was 1.39, with a sensitivity of 52.3% and a specificity of 67.3%. [AUC: 0.620, 95% confidence interval (CI): 0.590–0.651, p < 0.001]. After adjusting for potential confounders, multivariate analysis showed that the high SIRI group (SIRI > 1.39) was a strong independent predictor of CA-AKI in patients undergoing elective PCI compared with the low SIRI group (SIRI ≤ 1.39) (odds ratio = 1.642, 95% CI: 1.274–2.116, p < 0.001). Additionally, COX regression analysis showed that SIRI > 1.39 was significantly associated with long-term mortality at a median follow-up of 2.8 years. [Hazard ratio (HR)=1.448, 95%CI: 1.188–1.765; p < 0.001]. Besides, Kaplan–Meier survival curve also indicated that the cumulative rate of mortality was considerably higher in the high SIRI group.

Conclusions

High levels of SIRI are independent predictors of CA-AKI and long-term mortality in patients undergoing elective PCI.

Keywords:

• Systemic inflammatory response index
• contrast-associated acute kidney injury
• mortality
• percutaneous coronary intervention

Acknowledgement

We would like to acknowledge the presentation of our research at the 34th Great Wall International Congress of Cardiology Asian Heart Society Congress 2023 held during September 7–10 at Beijing, China. The abstract titled ‘The association between systemic inflammatory response index and contrast-associated acute kidney injury in patients undergoing elective percutaneous coronary intervention’ was presented as poster at the Cardiovascular Innovations and Applications. The abstract can be accessed online at https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0059. We are grateful for the opportunity to share our work at this prestigious conference.

Disclosure statement

No potential conflict of interest was reported by the author(s).

IRB information

The study protocol fulfilled the requirements of the Declaration of Helsinki and was approved by the Ethics Committee of the Fujian Provincial Hospital, China (Ethics Approval no. K2019-07-011). Due to the retrospective nature, the patient’s informed consent is exempt.

Data availability statement

The datasets used and/or analyzed in this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This study was funded by a grant from the National Natural Science Foundation of China General Program (Grant no. 81873495, 82171569), Heart Failure Center Research Foundation of Fujian Provincial Hospital (supported by the Fujian Provincial Department of Finance), and National Key Clinical Specialty Construction Project of China (Cardiovascular Medicine 2021). The funders had no role in study design, data collection, follow-up of patients, data interpretation, and writing the manuscript.