Non-Invasive Liver Fibrosis Scores Are Associated With Contrast-Associated Acute Kidney Injury in Patients Undergoing Elective Percutaneous Coronary Intervention
Non-Invasive Liver Fibrosis Scores Are Associated With Contrast-Associated Acute Kidney Injury in Patients Undergoing Elective Percutaneous Coronary Intervention
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在接受选择性经皮冠状动脉介入治疗的患者中，非侵入性肝纤维化评分与造影剂相关的急性肾损伤相关
DOI：
10.1177/00033197221105745
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发表时间：
2022-05-31
期刊：
影响因子：
2.8
通讯作者：
Guo, Yan-Song
中科院分区：
文献类型：
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作者：
He, Hao-Ming;He, Chen;Guo, Yan-Song
先前的研究表明，非侵袭性肝纤维化评分(LFSS)与肾功能恶化有关。本研究旨在评价LFSS对冠心病(CAD)择期经皮冠状动脉介入治疗(PCI)患者造影剂相关性急性肾损伤(CA-AKI)的预测作用。这项回顾性研究涉及5627名患者。CA-AKI发生率为6.3%(n=353)。经多因素Logistic回归分析，非侵袭性LFSS包括FIB-5评分(FIB-5)、FIB-4评分(FIB-4)、天冬氨酸氨基转移酶/丙氨酸氨基转移酶比值(AAR)、天冬氨酸氨基转移酶/血小板比值指数是CA-AKI的独立危险因素(均P<0.05)，而Forns评分不是(P>；0.05)。与其他LFS相比，FIB-5(曲线下面积[AUC]=.644)的预测性能最高。限制三次样条法分析证实了LFSS与CA-AKI风险之间的近似线性关系。此外，在已建立的临床风险模型中加入FIB-5(AUC=.747；净重新分类改进[NRI]=.441，P<；.001；综合鉴别改进[IDI]=.008，P<；.001)或AAR(AUC=.747；NRI=.419，P<；.001；IDI=.006，P=.010)可以显著改善CA-AKI的预测。LFSS与CA-AKI显著相关，可能可作为早期识别接受择期经皮冠状动脉介入治疗的冠心病患者的预测工具。
Previous studies have demonstrated that non-invasive liver fibrosis scores (LFSs) are associated with kidney function deterioration. This study aimed to assess the predictive performance of LFSs in contrast-associated acute kidney injury (CA-AKI) in coronary artery disease (CAD) patients undergoing elective percutaneous coronary intervention (PCI). This retrospective study involved 5627 patients. The frequency of CA-AKI was 6.3% (n = 353). In a multivariate logistic analysis after adjustment, non-invasive LFSs, including fibrosis-5 score (FIB-5), fibrosis-4 score (FIB-4), aspartate aminotransferase to alanine aminotransferase ratio (AAR), and aspartate aminotransferase to platelet ratio index were independent risk factors for CA-AKI (all P < .05), whereas the Forns score was not (P > .05). The highest predictive performance was observed for FIB-5 (area under the curve [AUC] = .644) compared to other LFSs. A restricted cubic spline analysis confirmed approximately linear relationships between LFSs and risks of CA-AKI. Furthermore, adding FIB-5 (AUC = .747; net reclassification improvement [NRI] = .441, P < .001; integrated discrimination improvement [IDI] = .008, P < .001) or AAR (AUC = .747; NRI = .419, P < .001; IDI = .006, P = .010) to an established clinical risk model could significantly improve the prediction of CA-AKI. The LFSs were significantly associated with CA-AKI, possibly serving as predictive tools for early identification of CAD patients undergoing elective PCI that are at high risk of CA-AKI.