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Association of prealbumin levels with contrast-induced acute kidney injury in elderly patients with elective percutaneous coronary intervention

Authors You ZB, Lin KY, Zheng WP, Lin CJ, Lin F, Guo TL, Zhu PL, Guo YS

Received 16 January 2018

Accepted for publication 15 March 2018

Published 17 April 2018 Volume 2018:13 Pages 641—649

DOI https://doi.org/10.2147/CIA.S162764

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 3

Editor who approved publication: Dr Wu


Zhe-Bin You,1,* Kai-Yang Lin,2,* Wei-Ping Zheng,1 Chun-Jin Lin,1 Fan Lin,1 Tai-Lin Guo,1 Peng-Li Zhu,1 Yan-Song Guo2

1Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fujian Medical University, Fuzhou, People’s Republic of China; 2Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fujian Medical University, Fuzhou, People’s Republic of China

*These authors contributed equally to this work

Purpose: Inflammatory factors play a critical role in contrast-induced acute kidney injury (CI-AKI). Prealbumin, a nutritional and inflammatory indicator, is a well-established predictor of short- and long-term outcomes in numerous clinical conditions. The current study investigated the association of pre-procedural prealbumin levels with CI-AKI and long-term outcomes in geriatric patients after elective percutaneous coronary intervention (PCI).
Patients and methods: A total of 558 patients aged≥75 years, who underwent elective PCI between January 2012 and December 2015, were selected for the current study. Pre-procedural prealbumin levels were measured before PCI. Multivariable logistic regression and Cox proportional hazard regression analyses were performed to identify the independent risk factors for CI-AKI and long-term mortality.
Results: Out of 558 patients, 54 developed CI-AKI. The optimal cutoff value of prealbumin for detecting CI-AKI was 185.5 mg/L with 62.7% sensitivity and 70.4% specificity based on the receiver operating characteristic analysis (C-statistic=0.710; 95% confidence interval [CI] 0.673–0.751). Multivariable analysis demonstrated that prealbumin≤185.5 mg/L was significantly associated with CI-AKI (odds ratio [OR] 0.397; 95% CI 0.195–0.808; P=0.011). Cox regression analysis demonstrated that prealbumin≤185.5 mg/L was associated with long-term mortality (adjusted hazard ratio [HR] 0.525; 95% CI 0.289–0.952; P=0.034) during the follow-up.
Conclusion: Pre-procedural levels of prealbumin were independently associated with an increased risk of CI-AKI and long-term mortality in elderly patients undergoing elective PCI.

Keywords: prealbumin, contrast-induced acute kidney injury, percutaneous coronary intervention, elderly
 

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