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

• Published in: Journal of inflammation research Vol. 15; pp. 2959 - 2969
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 31.05.2022; Dove; Dove Medical Press
• Subjects: Angiography; Cardiac patients; contrast-associated acute kidney injury; coronary angiography; Immune response; Inflammation; Original Research; preprocedural; Risk factors; systemic immune inflammation index; China; contrast-associated acute kidney injury; preprocedural; systemic immune inflammation index; coronary angiography
• ISSN: 1178-7031; 1178-7031
• DOI: 10.2147/JIR.S364915

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). 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 × 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. 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). 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.