AUTHOR=Jiang Hangpan , Li Duanbin , Xu Tian , Chen Zhezhe , Shan Yu , Zhao Liding , Fu Guosheng , Luan Yi , Xia Shudong , Zhang Wenbin 

TITLE=Systemic Immune-Inflammation Index Predicts Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary Angiography: A Cross-Sectional Study

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.841601

DOI=10.3389/fmed.2022.841601

ISSN=2296-858X

ABSTRACT=<sec><title>Background and Aims</title><p>Systemic immune-inflammation index (SII) is an emerging indicator and correlated to the incidence of cardiovascular diseases. This study aimed to explore the association between SII and contrast-induced acute kidney injury (CI-AKI).</p></sec><sec><title>Methods</title><p>In this retrospective cross-sectional study, 4,381 subjects undergoing coronary angiography (CAG) were included. SII is defined as neutrophil count × platelet count/lymphocyte count. CI-AKI was determined by the elevation of serum creatinine (Scr). Multivariable linear and logistic regression analysis were used to determine the relationship of SII with Scr and CI-AKI, respectively. Receiver operator characteristic (ROC) analysis, structural equation model analysis, and subgroup analysis were also performed.</p></sec><sec><title>Results</title><p>Overall, 786 (17.9%) patients suffered CI-AKI after the intravascular contrast administration. The subjects were 67.1 ± 10.8 years wold, with a mean SII of 5.72 × 10<sup>11</sup>/L. Multivariable linear regression analysis showed that SII linearly increased with the proportion of Scr elevation (β [95% confidence interval, CI] = 0.315 [0.206 to 0.424], <italic>P</italic> &lt; 0.001). Multivariable logistic regression analysis demonstrated that higher SII was associated with an increased incidence of CI-AKI ([≥12 vs. &lt;3 × 10<sup>11</sup>/L]: odds ratio, OR [95% CI] = 2.914 [2.121 to 4.003], <italic>P</italic> &lt; 0.001). Subgroup analysis showed consistent results. ROC analysis identified a good predictive value of SII on CI-AKI (area under the ROC curve [95% CI]: 0.625 [0.602 to 0.647]). The structural equation model verified a more remarkable direct effect of SII (β = 0.102, <italic>P</italic> &lt; 0.001) on CI-AKI compared to C-reactive protein (β = 0.070, <italic>P</italic> &lt; 0.001).</p></sec><sec><title>Conclusions</title><p>SII is an independent predictor for CI-AKI in patients undergoing CAG procedures.</p></sec>