A Comparison Between Two Different Definitions of Contrast-Associated Acute Kidney Injury for Long-Term Mortality in Patients with Chronic Kidney Disease Undergoing Coronary Angiography

Figures & data

Table 1 Baseline Characteristics

Variables	Total (n = 4197)	CA-AKIA			CA-AKIB
		Yes (n=582)	No (n=3615)	P value	Yes (n=577)	No (n=3620)	P value
Age, y	67.56 ± 10.20	67.90 ±10.53	67.50 ± 10.15	0.380	68.41 ± 10.46	67.42 ± 10.15	0.031
Age≥75, n (%)	1141 (27.2)	177 (30.4)	964 (26.7)	0.067	184 (31.9)	957 (26.4)	0.007
Male sex, n (%)	2884 (68.7)	358 (61.5)	2526 (69.9)	<0.001	389 (67.4)	2495 (68.9)	0.499
CHF, n (%)	1009 (24.0)	221 (38.0)	788 (21.8)	<0.001	217 (37.6)	792 (21.9)	<0.001
CAD, n (%)	3226 (76.9)	407 (69.9)	2819 (78.0)	<0.001	433 (75.0)	2793 (77.2)	0.287
Stroke, n (%)	400 (9.5)	56 (9.6)	344 (9.5)	0.996	64 (11.1)	336 (9.3)	0.194
LVEF, %	54.56 ± 14.35	52.41 ± 14.60	54.92 ± 14.27	0.001	51.62 ± 14.67	55.03 ± 14.24	<0.001
Hypertension, n (%)	2885 (68.7)	368 (63.2)	2517 (69.6)	0.002	289 (67.4)	2496 (69.0)	0.491
Anemia, n (%)	2283 (54.7)	386 (66.4)	1897 (52.8)	<0.001	391 (67.9)	1892 (52.6)	<0.001
AMI, n (%)	876 (20.9)	136 (23.4)	740 (20.5)	0.123	132 (22.9)	744 (20.6)	0.222
eGFR mL/min/1.73 m^2,	42.86 ± 14.29	39.96 ± 16.02	43.33 ± 13.94	<0.001	38.32 ± 15.58	43.58 ± 13.94	<0.001
LDL-C, mmol/L	2.74 ± 0.96	2.72 ± 0.93	2.75 ± 0.97	0.617	2.73 ± 0.95	2.74 ± 0.97	0.658
HDL-C, mmol/L	0.97 ± 0.27	0.97 ± 0.27	0.96 ± 0.27	0.397	0.98 ± 0.27	0.96 ± 0.27	0.319
HS-CRP, mg/L	20.43 ± 36.75	35.23 ± 47.23	18.68 ± 34.91	<0.001	34.79 ± 45.17	18.68 ± 35.21	<0.001
SCR, μmol/L	174.39 ± 140.15	195.70 ± 169.09	170.96 ± 134.62	<0.001	202.15 ± 164.75	169.97 ± 135.32	<0.001
Hemoglobin, g/L	123.47 ± 21.50	116.56 ± 22.23	124.59 ± 21.17	0.001	116.23 ± 22.29	124.63 ± 21.14	<0.001
Hypoalbuminemia, n (%)	2313 (56.6)	360 (63.2)	1953 (55.6)	0.001	372 (66.3)	1941 (55.1)	<0.001
Serum albumin, g/L	33.90 ± 4.84	32.96 ± 5.41	34.06 ± 4.73	<0.001	32.65 ± 5.29	34.10 ± 4.47	<0.001
Cholesterol, mmol/L	4.48 ± 1.22	4.44 ± 1.20	4.49 ± 1.22	0.386	4.45 ± 1.20	4.49 ± 1.22	0.495
Beta-blocker, n (%)	2892 (72.9)	315 (63.4)	2577 (74.2)	<0.001	335 (68.2)	2557 (73.5)	0.016
Statins, n (%)	3211 (80.9)	336 (67.6)	2875 (82.8)	<0.001	365 (74.3)	2846 (81.8)	<0.001
PCI, n (%)	2492 (59.4)	309 (53.1)	2183 (60.4)	0.001	330 (57.2)	2162 (59.7)	0.270
Death, n (%)	991 (23.6)	195 (33.5)	796 (22.0)	<0.001	195 (33.8)	796 (22.0)	<0.001

Notes: CA-AKI_A, which was defined as an increase of ≥0.5 mg/dL or >25% in serum creatinine from baseline within 72 hours after coronary angiography. CA-AKI_B, which was defined as an increase of ≥0.3 mg/dL or >50% in serum creatinine from baseline within 48 hours after coronary angiography.

Abbreviations: CHF, chronic heart failure; CAD, coronary artery disease; LVEF, left ventricular ejection fraction; AMI, acute myocardial infarction; eGFR, estimated glomerular filtration rate; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; HS-CRP, high-sensitivity C-reactive protein; SCR, serum creatinine; PCI, percutaneous coronary intervention.

Figure 1 Kaplan-Meier curves for the long-term prognosis of patients with CA-AKI and without CA-AKI. (A) Kaplan-Meier for the long-term prognosis of patients with CA-AKI_A and without CA-AKI_A. (B) Kaplan-Meier for the long-term prognosis of patients with CA-AKI_B and without CA-AKI_B.

Notes: CA-AKI_A, which was defined as an increase of ≥0.5 mg/dL or >25% in serum creatinine from baseline within 72 hours after coronary angiography. CA-AKI_B, which was defined as an increase of ≥0.3 mg/dL or >50% in serum creatinine from baseline within 48 hours after coronary angiography.

Table 2 Univariable Analysis of Risk Factors for Long-Term Mortality

Variables	Univariable Analysis
	HR	95% CI	P value
Age	1.02	1.01–1.02	<0.001
Age≥75	1.41	1.23–1.61	<0.001
Male	1.07	0.94–1.23	0.309
CHF	2.14	1.88–2.45	<0.001
CAD	1.15	0.99–1.34	0.073
Stroke	1.30	1.07–1.59	0.009
Hypertension	0.93	0.82–1.06	0.302
Anemia	1.59	1.40–1.81	<0.001
AMI	1.34	1.15–1.55	<0.001
eGFR	0.98	0.97–0.98	<0.001
LDL-C	0.96	0.90–1.03	0.257
HDL-C	0.77	0.55–0.89	0.004
Hypoalbuminemia	1.62	1.41–1.86	<0.001
Cholesterol	1.09	0.94–1.27	0.275
Beta-blocker	0.94	0.81–1.09	0.440
Statins	0.98	0.82–1.16	0.771
PCI	0.86	0.76–0.97	0.016
CA-AKIA	1.73	1.48–2.03	<0.001
CA-AKIB	1.74	1.49–2.03	<0.001

Notes: CA-AKI_A, which was defined as an increase of ≥0.5 mg/dL or >25% in serum creatinine from baseline within 72 hours after coronary angiography. CA-AKI_B, which was defined as an increase of ≥0.3 mg/dL or >50% in serum creatinine from baseline within 48 hours after coronary angiography.

Abbreviations: CHF, chronic heart failure; CAD, coronary artery disease; AMI, acute myocardial infarction; eGFR, estimated glomerular filtration rate; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; PCI, percutaneous coronary intervention.

Figure 2 HR(95% CI) for long-term mortality. (A) HR(95% CI) for long-term mortality of CA-AKI_A. (B) HR(95% CI) for long-term mortality of CA-AKI_B. (C) The comparison of CA-AKI_A and CA-AKI_B.

Notes: CA-AKI_A, which was defined as an increase of ≥0.5 mg/dL or >25% in serum creatinine from baseline within 72 hours after coronary angiography. CA-AKI_B, which was defined as an increase of ≥0.3 mg/dL or >50% in serum creatinine from baseline within 48 hours after coronary angiography.

Abbreviation: PAR, the population attributable risk.

Data Sharing Statement

The dataset generated for this study is not publicly available, but is available from the corresponding author upon reasonable request.