Background
Methods
Patient selection
Endpoint and definitions
Study protocol
Statistical analysis
Results
Baseline characteristics
Variables | Total (n = 3450) | No. (%) of patients with available data | CI-AKI group (n = 248) | Non-CI-AKI group (n = 3202) | P value |
---|---|---|---|---|---|
Age, y | 62.94 ± 11.13 | 3450 (100) | 69.11 ± 11.13 | 62.45 ± 10.99 | < 0.001 |
Age > 75, n (%) | 571 (16.55) | 3450 (100) | 89 (35.89) | 482 (15.05) | < 0.001 |
Female sex, n (%) | 802 (23.25) | 3450 (100) | 67 (27.02) | 735 (22.95) | 0.145 |
Weight, kg | 64.89 ± 10.75 | 3419 (99.10) | 62.38 ± 10.71 | 65.07 ± 10.73 | < 0.001 |
SBP, mmHg | 128.85 ± 20.48 | 3439 (99.68) | 127.78 ± 25.55 | 128.93 ± 20.04 | 0.492 |
DBP, mmHg | 75.95 ± 11.91 | 3438 (99.65) | 74.74 ± 12.74 | 76.04 ± 11.84 | 0.123 |
HR, bpm | 75.07 ± 13.42 | 3437 (99.62) | 79.81 ± 17.07 | 74.71 ± 13.03 | < 0.001 |
Medical history | |||||
CAD, n (%) | 3077 (89.76) | 3428 (99.36) | 234 (95.12) | 2843 (89.34) | 0.004 |
Chronic heart failure, n (%) | 1961 (56.99) | 3441 (99.74) | 182 (73.39) | 1779 (55.72) | < 0.001 |
CKD, n (%) | 643 (18.64) | 3450 (100) | 114 (45.97) | 529 (16.52) | < 0.001 |
CKD stages | < 0.001 | ||||
Mild CKD, n (%) | 397 (11.51) | 50 (20.16) | 347 (10.84) | ||
Moderate CKD, n (%) | 177 (5.13) | 35 (14.11) | 142 (4.43) | ||
Severe CKD, n (%) | 69 (2.00) | 29 (11.69) | 40 (1.25) | ||
Hypotension, n (%) | 89 (2.58) | 3445 (99.86) | 28 (11.43) | 61 (1.91) | < 0.001 |
LVEF, % | 57.78 ± 12.26 | 3008 (87.19) | 51.17 ± 12.90 | 58.32 ± 12.05 | < 0.001 |
LVEF < 40%, n (%) | 294 (9.77) | 3008 (87.19) | 43 (18.94) | 251 (9.03) | < 0.001 |
HF symptoms, n (%) | 1876 (54.85) | 3420 (99.13) | 170 (68.55) | 1706 (53.78) | < 0.001 |
Hypertension, n (%) | 1962 (56.89) | 3449 (99.97) | 172 (69.35) | 1790 (55.92) | < 0.001 |
Hyperlipidemia, n (%) | 507 (14.70) | 3450 (100) | 27 (10.89) | 480 (14.99) | 0.079 |
Smoking, n (%) | 1371 (39.74) | 3450 (100) | 89 (35.89) | 1282 (40.04) | 0.198 |
Hypoalbuminemia, n (%) | 1334 (44.78) | 2979 (86.35) | 126 (69.61) | 1208 (43.17) | < 0.001 |
Anemia, n (%) | 1086 (31.81) | 3414 (98.96) | 116 (47.15) | 970 (30.62) | < 0.001 |
AMI, n (%) | 1300 (37.85) | 3435 (99.57) | 163 (65.99) | 1137 (35.66) | < 0.001 |
Diabetes, n (%) | 817 (23.69) | 3448 (99.94) | 71 (28.63) | 746 (23.31) | 0.058 |
Laboratory measurements | |||||
LDL-C, mmol/L | 2.74 ± 0.97 | 2874 (83.30) | 2.97 ± 1.01 | 2.72 ± 0.97 | 0.001 |
HDL-C, mmol/L | 1.00 ± 1.30 | 2872 (83.25) | 0.99 ± 0.27 | 1.00 ± 1.34 | 0.682 |
NTpro-BNP, pg/mL | 1374.48 ± 3404.48 | 2326 (67.42) | 5442.54 ± 8475.37 | 1092.05 ± 2492.00 | < 0.001 |
Hs-CRP, mg/L | 17.49 ± 33.91 | 2644 (76.64) | 42.16 ± 50.94 | 15.57 ± 31.42 | < 0.001 |
Lpa, mg/dL | 30.68 ± 34.43 | 3037 (88.03) | 31.28 ± 33.54 | 30.63 ± 34.50 | 0.785 |
SCR, μmol/L | 92.35 ± 42.37 | 3450 (100) | 117.14 ± 58.53 | 90.42 ± 40.23 | < 0.001 |
eGFR, mL/min/1.73 mm2 | 80.95 ± 25.55 | 3450 (100) | 67.81 ± 36.71 | 81.97 ± 24.18 | < 0.001 |
Serum urea nitrogen, mg/dL | 5.29 ± 2.55 | 3414 (98.96) | 6.85 ± 3.73 | 5.17 ± 2.40 | < 0.001 |
Hemoglobin, g/L | 132.98 ± 16.35 | 3072 (89.04) | 124.88 ± 20.52 | 133.52 ± 15.89 | < 0.001 |
HbA1c, % | 6.54 ± 1.32 | 2648 (76.75) | 6.78 ± 1.50 | 6.52 ± 1.31 | 0.024 |
Serum albumin, g/L | 35.23 ± 7.04 | 2979 (86.35) | 32.34 ± 4.58 | 35.42 ± 7.13 | < 0.001 |
Medications | |||||
ACEI/ARB, n (%) | 3019 (87.53) | 3449 (99.97) | 201 (81.38) | 2818 (88.01) | 0.002 |
Beta blocker, n (%) | 2919 (84.63) | 3449 (99.97) | 176 (70.97) | 2743 (85.69) | < 0.001 |
Statin, n (%) | 3314 (96.09) | 3449 (99.97) | 233 (94.33) | 3081 (96.22) | 0.140 |
Diuretics, n (%) | 654 (18.96) | 3449 (99.97) | 118 (47.58) | 536 (16.74) | < 0.001 |
Antibiotic, n (%) | 527 (17.11) | 3080 (89.28) | 73 (39.25) | 454 (15.69) | < 0.001 |
CCB, n (%) | 594 (17.26) | 3442 (99.77) | 37 (15.10) | 557 (17.42) | 0.354 |
PPI, n (%) | 1456 (42.30) | 3442 (99.77) | 154 (62.60) | 1302 (40.74) | < 0.001 |
Metformin, n (%) | 81 (2.63) | 3079 (89.25) | 2 (1.08) | 79 (2.73) | 0.236 |
Procedure | |||||
PCI, n (%) | 2087 (67.65) | 3085 (89.42) | 143 (76.06) | 1944 (67.10) | 0.011 |
Contrast volume, mL | 126.53 ± 64.54 | 3447 (99.91) | 135.44 ± 64.34 | 125.84 ± 66.50 | < 0.001 |
Contrast volume > 155, n (%) | 852 (24.72) | 3447 (99.91) | 80 (32.26) | 772 (24.13) | 0.004 |
Peri-procedure IABP, n (%) | 133 (3.86) | 3450 (100) | 57 (22.98) | 76 (2.37) | < 0.001 |
The association between CI-AKI and prognosis
Risk factors for CI-AKI
Univariable | Multivariable | |||
---|---|---|---|---|
Variables | OR (95% CI) | P value | OR (95% CI) | P value |
Hypoalbuminemia | 3.02 (2.18–4.18) | < 0.001 | 1.48 (1.03–2.13) | 0.033 |
HF symptoms | 1.87 (1.42–2.47) | < 0.001 | 2.12 (1.46–3.06) | < 0.001 |
High contrast volume | 1.50 (1.13–1.98) | 0.005 | 1.60 (1.14–2.24) | 0.006 |
Hypotension | 6.64 (4.16–10.60) | < 0.001 | 2.70 (1.06–6.86) | 0.037 |
Age > 75 years | 3.16 (2.40–4.17) | < 0.001 | 2.02 (1.41–2.88) | < 0.001 |
Weight, kg | 0.98 (0.96–0.99) | < 0.001 | ||
Serum urea nitrogen, mg/dL | 1.17 (1.13–1.21) | < 0.001 | ||
Hypertension | 1.78 (1.35–2.36) | < 0.001 | 1.45 (1.01–2.08) | 0.042 |
Anemia | 2.02 (1.56–2.63) | < 0.001 | ||
Coronary artery disease | 2.33 (1.29–4.20) | 0.005 | ||
Mild CKD vs non-CKD | 2.87 (2.04–4.05) | < 0.001 | 2.23 (1.46–3.40) | < 0.001 |
Moderate CKD vs non-CKD | 4.92 (3.27–7.40) | < 0.001 | 3.39 (2.05–5.62) | < 0.001 |
Severe CKD vs non-CKD | 14.46 (8.70–24.05) | < 0.001 | 6.95 (3.48–13.90) | < 0.001 |
LVEF < 40 | 2.36 (1.65–3.36) | < 0.001 | ||
Acute myocardial infarction | 3.50 (2.66–4.60) | < 0.001 | 3.24 (2.29–4.58) | < 0.001 |
PCI | 1.56 (1.10–2.20) | 0.012 |