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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
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