The Relationship between Perioperative Serum Albumin and Contrast-induced Acute Kidney Injury in Patients after Percutaneous Coronary intervention

Abstract

Abstract Objective Contrast-induced acute kidney injury (CI-AKI) is a common complication in patients undergoing percutaneous coronary intervention (PCI). Studies have shown that perioperative serum albumin levels may play a role in the occurrence of CI-AKI. This study aimed to investigate the effect of perioperative serum albumin (delta Albumin or &Alb) on the occurrence and long-term prognosis of CI-AKI after PCI. Methods A total of 959 patients who underwent PCI between January 2017 and January 2019 were selected for the study. Receiver operating characteristic curve was used to determine the optimal cut-off value of &Alb in predicting CI-AKI after PCI. Patients were divided into two groups based on the optimal cut-off value: the high &Alb group (&Alb ≥ 4.55 g/L) and the control group (&Alb < 4.55 g/L). The incidence of CI-AKI and major adverse cardiac events (MACE, including all-cause death, nonfatal myocardial infarction, and target vessel revascularization) was compared between the groups. Cox regression analysis was used to identify predictors of long-term prognosis after PCI. Results Of the 959 patients, 147(15.3%) developed CI-AKI after PCI. The CI-AKI group had a higher level of delta Albumin than the non-CI-AKI group ([6.14 (3.90–9.10) versus 3.48 (4.31–6.57), P < 0.01)]. The incidence of CI-AKI in the high & Alb group was significantly higher compared to the low group (23.6% versus 8.3%, P<0.01). After a 1-year follow-up, the incidence of MACE was significantly higher in the high delta Albumin group than in the low group (18.6% versus 14.5%, P = 0.030). Cox regression analysis confirmed that CI-AKI was an independent predictor of MACE at the 1-year follow-up (HR 1.43, 95% CI 1.04–1.96, P = 0.028). In addition, patients with low preoperative serum albumin had a significantly higher incidence of MACE than those with high preoperative serum albumin (23.2% versus 19.5%, P = 0.013). Conclusion In summary, baseline high delta Albumin levels are an independent risk factor for CI-AKI in patients after PCI. Furthermore, the occurrence of CI-AKI in the perioperative period is also an independent predictor of long-term prognosis after PCI. These findings highlight the importance of monitoring delta Albumin levels and taking steps to prevent CI-AKI in patients undergoing PCI.