Systemic Immune-Inflammation Index Predicts Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary Angiography: A Cross-Sectional Study

• Published in: Frontiers in medicine Vol. 9; p. 841601
• Main Authors: Jiang, Hangpan, Li, Duanbin, Xu, Tian, Chen, Zhezhe, Shan, Yu, Zhao, Liding, Fu, Guosheng, Luan, Yi, Xia, Shudong, Zhang, Wenbin
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 16-03-2022
• Subjects: contrast-induced acute kidney injury; coronary angiography; coronary artery disease; inflammation; Medicine; percutaneous coronary intervention; systemic immune-inflammation index; contrast-induced acute kidney injury; coronary artery disease; systemic immune-inflammation index; percutaneous coronary intervention; inflammation; coronary angiography
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2022.841601

Systemic immune-inflammation index (SII) is an emerging indicator and correlated to the incidence of cardiovascular diseases. This study aimed to explore the association between SII and contrast-induced acute kidney injury (CI-AKI).
In this retrospective cross-sectional study, 4,381 subjects undergoing coronary angiography (CAG) were included. SII is defined as neutrophil count × platelet count/lymphocyte count. CI-AKI was determined by the elevation of serum creatinine (Scr). Multivariable linear and logistic regression analysis were used to determine the relationship of SII with Scr and CI-AKI, respectively. Receiver operator characteristic (ROC) analysis, structural equation model analysis, and subgroup analysis were also performed.
Overall, 786 (17.9%) patients suffered CI-AKI after the intravascular contrast administration. The subjects were 67.1 ± 10.8 years wold, with a mean SII of 5.72 × 10
/L. Multivariable linear regression analysis showed that SII linearly increased with the proportion of Scr elevation (β [95% confidence interval, CI] = 0.315 [0.206 to 0.424],
< 0.001). Multivariable logistic regression analysis demonstrated that higher SII was associated with an increased incidence of CI-AKI ([≥12 vs. <3 × 10
/L]: odds ratio, OR [95% CI] = 2.914 [2.121 to 4.003],
< 0.001). Subgroup analysis showed consistent results. ROC analysis identified a good predictive value of SII on CI-AKI (area under the ROC curve [95% CI]: 0.625 [0.602 to 0.647]). The structural equation model verified a more remarkable direct effect of SII (β = 0.102,
< 0.001) on CI-AKI compared to C-reactive protein (β = 0.070,
< 0.001).
SII is an independent predictor for CI-AKI in patients undergoing CAG procedures.