PLATELET-TO-LYMPHOCYTE RATIO AFFECTS THE INCIDENCE OF CONTRAST-INDUCED NEPHROPATHY IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Abstract

Background : Contrast-induced nephropathy (CIN) is a condition of acute renal failure that is found after the administration of iodinated contrast media during angiography or other medical procedures. CIN is the third most common cause of acute kidney injury in hospitalized patients. CIN increased mortality, cardiovascular events, and hospital stay. Platelet-lymphocyte ratio (PLR) describes the degree of inflammation involved in the process of the CIN mechanism. Recent research stated PLR was an independent predictor of CIN. The purpose of this study was to explore the impact of PLR on the incidence of CIN in STEMI patients undergoing a primary PCI procedure.

Methods: This prospective observational study involved 61 STEMI patients who underwent primary percutaneous coronary intervention (PCI) procedures at the Haji Adam Malik General Hospital, Murni Teguh Memorial Hospital, and Grandmed Lubuk Pakam Hospital. PLR and baseline creatinine were assessed at the beginning of hospital admission, then creatinine evaluation was examined 48-72 hours after the primary PCI procedure. CIN was defined as an increase of creatinine ≥ 0.5 mg / dL or an increase of ≥ 25% from the initial creatinine 48-72 hours after the Primary PCI procedure.

Results: This study found that 11 (18.03%) subjects were experienced CIN. PLR value was significantly higher in patients experiencing CIN than not CIN (216.38 ± 69.46 and 146.29 ± 61.62, p = 0.001). PLR was positively correlated to the incidence of CIN (r = 0.394, p = 0.002). The PLR cut off value for CIN was 162.47, with a sensitivity of 81.8% and a specificity of 64%, and AUC value of 0.795. In bivariate analysis, PLR was found to be associated with CIN (p=0.008, with OR: 8.0, CI95% 1.556-41.134).

Conclusion: Platelet-to-lymphocyte ratio affects the incidence of CIN, and also has a positive correlation with CIN. It is found that the probability of CIN is in accordance with the PLR value significantly with cutoff 162.47.