Predictive value of C-reactive protein,albumin and their ratio on contrast-induced nephropathy after coronary angiography
Objective To explore the predictive value of C-reactive protein(CRP),albumin(ALB),and their ratio(CAR)for contrast-enhanced nephropathy(CIN)after coronary angiography(CAG)in patients with acute coronary syndrome(ACS).Methods ACS patients who underwent CAG surgery in the Cardiology Department of Taian Central Hospital from December 1,2019 to March 30,2022 were selected as the research subjects.After admission,relevant examinations were completed and general information,CRP and ALB serum concentrations of patients were collected.Venous blood samples were taken from the patients 48 and 72 hours before and after CAG,and serum creatinine levels were measured.Patients were randomly divided into CIN group(n=50)and non CIN group(n=591)based on the diagnostic criteria of CIN.Finally,the statistical significance of the relevant detection indicators in the two patient groups was compared,and correlation between various indicators and CIN occurrence was analysed.The receiver operating characteristic(ROC)curve was drawn and the early evaluative value of the CAR for CIN occurrence was assessed.Results The incidence rate of CIN was 7.8％(50/641).The levels of CRP(Z=0.007,P＜0.001),ALB(Z=0.003,P＜0.001)and CAR(Z=0.005,P＜0.001)in CIN group were higher than those in non CIN group,with statistical significance.The Spearman correlation analysis results showed that the occurrence of CIN after CAG was positively correlated with the levels of CRP(r=0.493,P＜0.001)and CAR(r=0.279,P＜0.001),and negatively correlated with the levels of ALB(r=-0.335,P＜0.001).The results of logistic regression analysis showed that CRP(OR=1.288,P＜0.001,95％CI:1.170-1.417),CAR(OR=0.234,P=0.026,95％CI:0.065-0.839),and ALB(OR=0.634,P＜0.001,95％CI:0.539-0.747)were independent risk factors for predicting the occurrence of CIN after CAG surgery.According to the ROC curve,the area under the CRP curve was 0.934,with a cutoff point of 6.15,the susceptibility of 96.0％,and specificity of 74.5％;the area under,the ALB curve was 0.930,with a cutoff point of 39.45,the susceptibility of 88.3％,and the specificity of 86.0％;the area under the CAR curve was 0.968,with a cutoff point of 0.21,the susceptibility of 94.0％,and the specificity of 88.5％.Conclusion CAR can serve as a serum marker for early prediction of CIN occurrence after CAG surgery,and has high sensitivity and specificity.
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