The influence of different inflammatory cytokines levels on the incidence of contrast-induced acute kidney injury in patients with acute coronary syndrome following percutaneous coronary intervention
Objective:To investigate the predictive value of various serum inflammatory cytokines for contrast-in-duced acute kidney injury(CI-AKI)in patients with acute coronary syndrome(ACS)undergoing percutaneous coro-nary intervention(PCI).Methods:A total of 464 patients who underwent PCI in Zhongda Hospital,Southeast Uni-versity from January 2023 to December 2023 were consecutively enrolled.Patients were divided into the CI-AKI group(n=72)and the non-CI-AKI group(n=392)based on the occurrence of CI-AKI.Inflammatory cytokines assessed were IL-2,IL-4,IL-6,IL-10,IL-17,TNF-α and γ-IFN.Multivariate Logistic regression was used to identi-fy risk factors for CI-AKI,and ROC curves were utilized to evaluate the predictive value of cytokines for CI-AKI.Results:Serum IL-2,IL-6,IL-17 and γ-IFN levels in the CI-AKI group were significantly higher than those in the non-CI-AKI group(P＜0.05),while IL-10 level was significantly lower in the CI-AKI group compared to the non-CI-AKI group(P＜0.05).Multivariate Logistic regression showed that 1L-2≥0.24 pg·mL-1,IL-6 ≥5.37 pg·mL-1,IL-10＜1.24 pg·mL-1,IL-17 ≥0.49 pg·mL-1 and γ-IFN≥0.78 pg·mL-1were significantly associated with CI-AKI.In the multivariate predictive model incorporating 2-3 inflammatory cytokines,combination 5[area under the curve(AUC)=0.688,95％CI:0.613-0.755]and combination 16(AUC=0.730,95％CI:0.683-0.785)which included IL-6+IL-10 and IL-2+IL-17+γ-IFN demonstrated higher AUC.The combination 22 in-volving all 7 inflammatory cytokines exhibited the best predictive performance(AUC=0.773,95％CI:0.718-0.826),significantly enhancing the AUC of the Mehran score for predicting CI-AKI(P＜0.05).Conclusion:Ser-um levels of various inflammatory cytokines are associated with the development of CI-AKI,and the combined pre-dictive models including inflammatory cytokines IL-2,IL-4,IL-6,IL-10,IL-17,TNF-α and γ-IFN have potential prognostic value for predicting CI-AKI in patients with ACS undergoing PCI.
万方数据
维普
