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  • Title: Impact of small and dense low-density lipoprotein (sd-LDL)on contrast-induced acute kidney injury in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
    Author: Li Y, Ma K, Shen G, Zheng D, Xuan Y, Li W.
    Journal: Int Urol Nephrol; 2021 Dec; 53(12):2611-2617. PubMed ID: 33675477.
    Abstract:
    OBJECTIVE: To investigate the impact of serum small and dense low-density lipoprotein (sd-LDL) on contrast-induced acute kidney injury (CI-AKI) after emergency percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). METHOD: From November 2019 to August 2020, 352 patients with STEMI who underwent primary PCI were recruited consecutively. Patients were divided into CI-AKI group (n = 71) and non-CI-AKI group (n = 281). CI-AKI was defined as an increase in serum creatinine (≥ 25% or ≥ 0.5 mg/dL) from baseline occurring 72 h after PCI. All subjects were tested for sd-LDL. RESULTS: In the 352 eligible patients with STEMI receiving emergency PCI, 71 patients (20.2%) developed CI-AKI. The levels of sd-LDL in CI-AKI group was higher than those in the non-CI-AKI group, and the difference was statistically significant (P < 0.05). The area under the curve (AUC) of the sd-LDL was 0.741 [95% confidence interval (CI) 0.538-0.636] in the STEMI patients receiving emergency PCI. CI-AKI model included the following five predictors: sd-LDL, NLR, Diabetes, Pre-PCI eGFR, and Log NT-proBNP. The AUC of forecast probability was 0.835 [95% confidence interval (CI) 0.786-0.883].The Hosmer-Lemeshow test has a P value of 0.519, which confirms the model's goodness of fit. CONCLUSION: Increased sd-LDL is independently associated with risk of CI-AKI in STEMI patients treated by primary PCI.
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