Analysis of the prediction value of prognostic nutritional index for acute kidney injury after percutaneous coronary intervention in acute myocardial infarction
Analysis of the prediction value of prognostic nutritional index for acute kidney injury after percutaneous coronary intervention in acute myocardial infarction
Objective:To demonstrate the prediction value of the prognostic nutritional index(PNI)for acute kidney injury(AKI)after PCI in patients with acute myocardial infarction(AMI).Methods:A total of 160 patients with AMI who underwent emergency PCI in our hospital from April 2022 to April 2023 were enrolled.Based on the occurrence of AKI after the procedure,patients were divided into control group(n=98)and AKI group(n=62).The clinical data included age,gender,body weight,smoking history,medical history(including hypertension and diabetes),echocardiography,lymphocyte count(LYM),serum albumin(ALB),TC,TG,HGB,SCr,estimated glomerular filtration rate(eGFR),blood urea nitrogen(BUN),NT-proBNP,and CK-MB were collected.The PNI was calculated.Multivariate Logistic regression analysis was performed to determine the factors influencing the occurrence of AKI after PCI in AMI patients.Receiver operator characteristic(ROC)curve analysis was used to assess the prediction value of PNI for the occurrence of AKI in AMI patients after PCI.Results:Compared with the control group,the level of LVEF in AKI group was significantly lower,(50.3±5.4)％vs.(58.4±7.1)％(P＜0.001).ALB(36.2±4.4)vs.(41.1±4.7)g/L(P＜0.001),HGB(121.9±14.4)vs.(131.5±16.3)g/L(P＜0.001),LYM(1.4±0.6)vs.(1.7±0.7)×109/L(P＜0.001)and PNI score(44.6±4.6)vs.(49.4±6.3)score(P＜0.001)were significantly lower.SCr(0.055±0.012)vs.(0.061±0.018)pmol/L(P＜0.05),NT-proBNP(1 219±310)vs.(2 941±1 429)ng/L(P＜0.001)and CK-MB(38.1±11.9)vs.(46.4±13.5)pg/L(P＜0.001)levels were significantly higher.The multivariate Logistic regression analysis showed that decreased ALB,decreased HGB,decreased LYM,increased SCr,increased NT-proBNP,increased CK-MB,decreased LVEF,and decreased PNI score were all independent risk factors for AKI in AMI patients after PCI(OR＞1,P＜0.05).The ROC curve results showed that the AUC of PNI score was 0.848(95％CI:0.791-0.905,P＜0.001),with a sensitivity of 57.10％and specificity of 98.40％when the PNI score was 37.49.Conclusions:PNI has excellent prediction value for the occurrence of AKI after PCI in AMI patients,providing a new predictive indicator for timely monitoring and assessment of the risk of AKI after PCI in clinical practice.
维普
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