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Original Research

Development and Validation of a Risk Nomogram Model for Predicting Contrast-Induced Acute Kidney Injury in Patients with Non-ST-Elevation Acute Coronary Syndrome Undergoing Primary Percutaneous Coronary Intervention

ORCID Icon, , , , , & show all
Pages 65-77 | Published online: 26 Jan 2022

Figures & data

Figure 1 Study flow diagram.

Abbreviations: NSTE-ACS, non-ST elevation acute coronary syndrome; PCI, percutaneous transluminal coronary intervention; eGFR, estimated glomerular filtration rate; NYHA, New York Heart Association.
Figure 1 Study flow diagram.

Table 1 Comparison of Baseline Features and PCI Results in the Training Cohort

Table 2 Comparison of Laboratory Test Results in the Training Cohort

Table 3 Multivariate Logistic Regression Analysis for the Occurrence of CI-AKI After PCI in Patients with NSTE-ACS in Training Cohort

Figure 2 LASSO regression model screening predictors. (A) Vertical lines are plotted at the most available parameter value λ = 0.0105, and the selected variables are 15; (B) Plot of each clinical characteristic coefficient against log(λ) by adjusting the parameter λ.

Figure 2 LASSO regression model screening predictors. (A) Vertical lines are plotted at the most available parameter value λ = 0.0105, and the selected variables are 15; (B) Plot of each clinical characteristic coefficient against log(λ) by adjusting the parameter λ.

Figure 3 The nomogram for predicting the occurrence of CI-AKI after PCI in patients with NSTE-ACS. The final score (ie, total points) is calculated as the sum of the individual scores of each of the six variables included in the nomogram.

Abbreviations: CI-AKI, contrast-induced acute kidney injury; PCI, percutaneous transluminal coronary intervention; NSTE-ACS, non-ST elevation acute coronary syndrome; DM, diabetes mellitus; LVEF, left ventricular ejection fraction; FAR, fibrinogen-to-albumin ratio; LY, lymphocyte count; hsCRP, High-sensitive C-reactive protein.
Figure 3 The nomogram for predicting the occurrence of CI-AKI after PCI in patients with NSTE-ACS. The final score (ie, total points) is calculated as the sum of the individual scores of each of the six variables included in the nomogram.

Figure 4 Calibration curve of the nomogram for the training set (A) and the validation set (B). The X-axis represents the overall predicted probability of CI-AKI after PCI and the Y -axis represents the actual probability. Model calibration is indicated by the degree of fitting of the curve and the diagonal.

Figure 4 Calibration curve of the nomogram for the training set (A) and the validation set (B). The X-axis represents the overall predicted probability of CI-AKI after PCI and the Y -axis represents the actual probability. Model calibration is indicated by the degree of fitting of the curve and the diagonal.

Figure 5 ROC curve of the nomogram for predicting CI-AKI after PCI in NSTE-ACS patients. (A) ROC curve in the training set; (B) ROC curve in the validation set.

Abbreviations: AUC, area under the ROC curve; ROC, receiver operating characteristic; PCI, percutaneous transluminal coronary intervention; NSTE-ACS, non-ST elevation acute coronary syndrome.
Figure 5 ROC curve of the nomogram for predicting CI-AKI after PCI in NSTE-ACS patients. (A) ROC curve in the training set; (B) ROC curve in the validation set.

Figure 6 The receiver operator characteristic curves of the nomogram and the Mehran Score.

Abbreviation: AUC, area under the curve.
Figure 6 The receiver operator characteristic curves of the nomogram and the Mehran Score.

Figure 7 Decision curve analysis for the training set (A) and the validation set (B). A horizontal line indicates that all samples are negative and not treated, with a net benefit of zero. An oblique line indicates that all samples are positive. The net benefit has a negative slope.

Figure 7 Decision curve analysis for the training set (A) and the validation set (B). A horizontal line indicates that all samples are negative and not treated, with a net benefit of zero. An oblique line indicates that all samples are positive. The net benefit has a negative slope.

Figure 8 The clinical impact curve of the validation cohort is drawn based on the nomogram. Clinical impact curve of the nomogram plots the number of CI-AKI patients classified as high risk, and the number of cases classified as high risk with the event at each risk threshold.

Figure 8 The clinical impact curve of the validation cohort is drawn based on the nomogram. Clinical impact curve of the nomogram plots the number of CI-AKI patients classified as high risk, and the number of cases classified as high risk with the event at each risk threshold.