General data.
We selected 235 patients with acute myocardial infarction who underwent PCI in the Affiliated Hospital of Jiangsu University from January 2018 to March 2022. The inclusion criteria were: (1) patients with acute myocardial infarction who met the diagnostic criteria; (2) patients with existing renal function data taken before PCI, within 3 days after PCI, within 3 days to 1 month after PCI, and within 1 month to 1 year after PCI. The exclusion criteria were: (1) patients with allergies to iodine or iodine contrast agent; (2) patients with phase 5 chronic renal insufficiency or maintenance hemodialysis/peritoneal dialysis; (3) patients with a previous kidney transplant. The study protocol fulfilled the requirements of the Declaration of Helsinki.This study was approved by the Ethics Committee of the Affiliated Hospital of Jiangsu University. Informed consent was obtained from all subjects and/or their legal guardian(s).
Therapeutic method.
All patients were loaded with dual antiplatelet therapy before the operation. According to the results of coronary angiography, PCI was only performed on Culprit vessels. Whether to use ACEI/ARB β receptor blockers or calcium antagonists was determined by the attending physician according to each patient's condition. After PCI, 500 ml of 0.9% normal saline was injected intravenously and preventive hydration treatment was performed at a rate of 1 ml/(kg * h). We avoided using nephrotoxic drugs such as quinolones, sulfonamide antibiotics, non-steroidal antipyretics, and chemotherapeutic drugs.
Data collection.
We collected the clinical data (age, sex, BMI, systolic blood pressure, diastolic blood pressure, heart rate, type of myocardial infarction, and preoperative hypotension), past medical history (hypertension, diabetes, anemia, smoking, drinking, hyperlipidemia, old myocardial infarction, and PCI), laboratory examination data (albumin, blood urea nitrogen, uric acid, triacylglycerol, cholesterol, low-density lipoprotein, high-density lipoprotein, white blood cell, hemoglobin, hs-CRP, glycosylated hemoglobin, urine routine PH, and LVEF (%)), perioperative medication data (ACEI/ARB β-receptor antagonists, CCB), coronary artery occlusion data (left main artery, left anterior descending branch, left circumflex branch, and right coronary artery), the occurrence of acute renal failure, and both the glomerular filtration rate and blood creatinine levels (at admission, within 3 days of treatment, within 3 days to 1 month of treatment, and within 1 month to 1 year of treatment) of patients.
Grouping method.
Patients were divided into the CIN group and non-CIN group (according to whether CIN had occurred) in order to explore the impact of CIN occurrence on the prognosis of renal function.
Definition of contrast-induced nephropathy.
Within 72 hours after the contrast agent examination, if the serum creatinine value rose either > 44.2 µmol/L or 25% higher than before the examination, it was determined as CIN10, 11.
Statistical methods.
For the comparison of data between the two groups, the Student’s t test was used for measurement data, while either the chi-square or the Fisher exact test was used for exact test counting data. The serum creatinine trends of patients at different time periods were represented by a line chart. The relationship between the AKI and CIN of patients was represented by a histogram. All statistical analyses were performed using SPSS statistical software.