THE RELATIONSHIP BETWEEN THE RISK FACTORS OF CI-AKI AND MACE AND THE CYS C LEVEL IN ELDERLY PATIENTS AFTER PCI

Airong Fu, Jun Liao^*, Wei Wang

Department of Cardiology, The first people’s hospital of Huzhou (the first affiliated hospital of Huzhou teacher’s college), Huzhou, 313000, PR China

Objective: To investigate the risk factors of contrast-induced acute kidney injury (CI-AKI) and major adverse cardiovascular events (MACE) in follow-up period in elderly patients after percutaneous coronary intervention (PCI) and the relationship between these risk factors and cystatin C(CysC) level. 

Methods: A total of 424 elderly patients who received PCI in our hospital from January 2017 to May 2020 were included in this study, and they were divided into groups according to the level of CysC. Univariate and multivariate methods were used to analyze the independent influencing factors of CI-AKI and MACE risk during follow-up, and ROC curve was drawn to evaluate the effectiveness of CysC level in predicting CI-AKI risk.

Results: The incidence of CI-AKI during hospitalization, age, proportion of patients with hy-pertension, type 2 diabetes mellitus (T2DM), old myocardial infarction, left ventricular ejection fraction (LVEF)<40%, myocardial infarction, perioperative diuretic, preoperative levels of CysC and SCr in the group with CysC>1.5 mg/L were significantly higher than those in the group with CysC≤1.5mg/L (P<0.05). The level of estimated glomerular filtration rate (eGFR) in the group with CysC >1.5 mg/L was significantly lower than that in the group with CysC≤1.5mg/L (P < 0.05). Multivariate analysis showed that the level of CysC was an independent influencing factors of CI-AKI (OR=1.72, 95% CI: 1.30~2.83, P=0.00). ROC curve analysis showed that CysC could be used to predict the risk of CI-AKI, AUC=0.81 (95% ci: 0.69~0.93), the best cut-off value was 1.5mg/L, and the sensitivity and specificity were 79.84% and 72.66% respectively (p<0.05). The total incidence of MACE and the incidence of target vessel revascularization in CysC>1.5 mg/L group were significantly higher than those in CysC≤1.5mg/L group (P<0.05). Cox regression analysis showed that CysC>1.5 mg/L was an independent influencing factor of MACE risk during follow-up period (RR=18.24, 95% CI: 2.12-39.67, P=0.00). 

Conclusion: CI-AKI and MACE in follow-up period are closely related to high CysC level in elderly patients after PCI.