Preprocedural High-Sensitivity C-Reactive Protein Predicts Contrast-Induced Nephropathy and Long-Term Outcome After Coronary Angiography

Abstract

We investigated whether high-sensitivity C-reactive protein (hsCRP) levels were associated with contrast-induced nephropathy (CIN) and long-term mortality after coronary angiography (CAG). Patients (N = 2133) undergoing CAG with preprocedural hsCRP were consecutively enrolled. High-sensitivity C-reactive protein was measured before angiography. Median follow-up was 2.3 years. The overall incidence of CIN was 2.77% (59 of 2133). There was a positive trend of hsCRP quartiles (Q) with rates of CIN: 0.9% for Q1 (<1.6 mg/L), 0.9% for Q2 (1.6-3.9 mg/L), 2.4% for Q3 (4.0-11.3mg/L), and 6.8% for Q4 (>11.3 mg/L; P < .05). The receiver operating characteristic (ROC) analysis showed that the cutoff point of hsCRP was 7.3 mg/L for predicting CIN with a 72.7% sensitivity and a 67.0% specificity (area under the curve [AUC] = 0.742, 95% confidence interval [CI] 0.672-0.810; P < .05). The predictive value of hsCRP was similar to the Mehran score for CIN (AUC = 0.742 vs AUC = 0.801; P = .228). After adjustment for other potential risk factors, hsCRP >7.3 mg/L still was an independent predictor of CIN (odds ratio [OR] = 2.83, 95% CI: 1.44-5.58; P = .003). Furthermore, hsCRP >7.3 mg/L was associated with higher mortality (OR = 2.04, 95% CI: 1.30-3.19; P = .002).

Increased urinary adiponectin level is associated with contrast-induced nephropathy in patients undergoing elective percutaneous coronary intervention

“…As shown in Table 3, Univariate logistic regression found that diabetes mellitus, Scr > 124 μmol/L and UAPN> 12.24 ng/ml were associated with CIN (all P < 0.05). The contrast volume > 300 ml and Hs-CRP as common risk factor used in clinical practice were also included in the multivariate logistic regression analysis [16, 17]. Multivariate analysis indicated that UAPN> 12.24um/ml (OR, 5.071; 95% CI, 1.711–15.028; P < 0.01) and Scr > 124 μmol/L (OR, 4.210; 95% CI, 1.297–13.669; P < 0.01) remained significant predictors for developing CIN in patients undergoing elective PCI (Table 4).…”

The Ratio of Fibrinogen to Albumin as a Predictor of Contrast-Induced Nephropathy After Carotid Angiography

“…33 C-reactive protein was found to be an independent predictor of CIN after coronary angiography. 34 In recent studies, PLR and NLR emerged as independent predictors of CIN in patients with STEMI after primary PCI. 18,35 In our study, we showed that PLR is associated with an increased risk of CIN.…”

Preventive Effects of Alprostadil Against Contrast-Induced Nephropathy Inpatients With Renal Insufficiency Undergoing Percutaneous Coronary Intervention

“…C-reactive protein and IL-6 are markers of inflammatory response and are also closely related to CIN. [25][26][27] In this study, whether in the alprostadil group or in the control group, CRP and IL-6 levels were higher after operation at 48 and72 hours compared with baseline (P < .05), indicating that the use of contrast agent had an inflammatory reaction. In the alprostadil group after operation at 48 and 72 hours, CRP and IL-6 levels were lower compared with the control group (P < .05), which indicated that the treatment with alprostadil had an antiinflammatory effect.…”