Objective: Contrast-induced nephropathy (CIN) is associated with significantly increased morbidity and mortality after percutaneous coronary intervention (PCI). Patients with acute coronary syndrome (ACS) are at higher risk of CIN. The platelet-to-lymphocyte ratio (PLR) is closely linked to inflammatory conditions. We hypothesized that PLR levels on admission can predict the development of CIN after PCI for ACS. Subjects and Methods: A total of 426 patients (mean age 63.17 ± 13.01 years, 61.2% males) with ACS undergoing PCI were enrolled in this study. Admission PLR levels were measured before PCI. Serum creatinine values were measured before and within 72 h after the administration of contrast agents. Patients were divided into 2 groups: the CIN group and the no-CIN group. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dl or 25% above baseline within 72 h after contrast administration. Results: CIN developed in 53 patients (15.9%). Baseline PLR was significantly higher in patients who developed CIN compared to those who did not (160.8 ± 29.7 and 135.1 ± 26.1, respectively; p < 0.001). Multivariate analyses found that PLR [odds ratio (OR) 3.453, 95% confidence interval (CI) 1.453-8.543; p = 0.004] and admission creatinine (OR 6.511, 95% CI 1.759-11.095; p = 0.002) were independent predictors of CIN. Conclusions: The admission PLR level is an independent predictor of the development of CIN after PCI in ACS.

1.
Goldfarb S, McCullough PA, McDermott J, et al: Contrast-induced acute kidney injury: specialty-specific protocols for interventional radiology, diagnostic computed tomography radiology, and interventional cardiology. Mayo Clin Proc 2009;84:170-179.
2.
Finn WF: The clinical and renal consequences of contrast-induced nephropathy. Nephrol Dial Transplant 2006;21:i2-i10.
3.
McCullough PA: Contrast-induced acute kidney injury. J Am Coll Cardiol 2008;51:1419-1428.
4.
Recio-Mayoral A, Chaparro M, Prado B, et al: The reno-protective effect of hydration with sodium bicarbonate plus N-acetylcysteine in patients undergoing emergency percutaneous coronary intervention: the RENO study. J Am Coll Cardiol 2007;49:1283-1288.
5.
Lazaros G, Tsiachris D, Tousoulis D, et al: In-hospital worsening renal function is an independent predictor of one-year mortality in patients with acute myocardial infarction. Int J Cardiol 2012;155:97-101.
6.
Bartholomew BA, Harjai KJ, Dukkipati S, et al: Impact of nephropathy after percutaneous coronary intervention and a method for risk stratification. Am J Cardiol 2004;93:1515-1519.
7.
Mehran R, Aymong ED, Nikolsky E, et al: A simple risk score form prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol 2004;44:1393-1399.
8.
Senoo T, Motohiro M, Kamihata H, et al: Contrast-induced nephropathy in patients undergoing emergency percutaneous coronary intervention for acute coronary syndrome. Am J Cardiol 2010;105:624-628.
9.
McCullough PA, Stacul F, Becker CR, et al; CIN Consensus Working Panel: Contrast-Induced Nephropathy (CIN) Consensus Working Panel: executive summary. Rev Cardiovasc Med 2006;7:177-197.
10.
Lai Q, Lerut J: Reply to ‘neutrophil and platelet-to-lymphocyte ratio: new predictors of dropout and recurrence after liver transplantation for hepatocellular cancer?' Transpl Int 2014;27:e34-e35.
11.
Schiller NB, Shah PM, Crawford M, et al: Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms (review). J Am Soc Echocardiogr 1989;2:358-367.
12.
Azab B, Shah N, Akerman M, McGinn JT Jr: Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis 2012;34:326-334.
13.
McCullough PA, Soman SS: Contrast-induced nephropathy. Crit Care Clin 2005;21:261-280.
14.
Fox CS, Muntner P, Chen AY, et al: Short-term outcomes of acute myocardial infarction in patients with acute kidney injury: a report from the national cardiovascular data registry. Circulation 2012;125:497-504.
15.
McCullough PA, Wolyn R, Rocher LL, et al: Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med 1997;103:368-375.
16.
Wi J, Ko YG, Shin DH, et al: Prediction of contrast-induced nephropathy with persistent renal dysfunction and adverse longterm outcomes in patients with acute myocardial infarction using the Mehran risk score. Clin Cardiol 2013;36:46-53.
17.
Goldenberg I, Matetzky S: Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. CMAJ 2005;172:1461-1471.
18.
Ronco C, McCullough P, Anker SD, et al; Acute Dialysis Quality Initiative (ADQI) consensus group: Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative. Eur Heart J 2010;31:703-711.
19.
Ronco C, Haapio M, House AA, et al: Cardiorenal syndrome. J Am Coll Cardiol 2008;52:1527-1539.
20.
Heyman SN, Reichman J, Brezis M: Pathophysiology of radiocontrast nephropathy: a role for medullary hypoxia. Invest Radiol 1999;34:685-691.
21.
McCullough PA: Acute kidney injury with iodinated contrast. Crit Care Med 2008;36(suppl 4):S204-S211.
22.
Gary T, Pichler M, Belaj K, et al: Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One 2013;8:676-688.
23.
Kaya A, Kaya Y, Topçu S, Günaydin ZY, Kurt M, Tanboğa IH, Kalkan K, Aksakal E: Neutrophil-to-lymphocyte ratio predicts contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention. Angiology 2014;65:51-56.
24.
McCullough PA, Adam A, Becker CR, et al; CIN Consensus Working Panel: Risk prediction of contrast induced nephropathy. Am J Cardiol 2006;98:27K-36K.
25.
Cho JY, Jeong MH, Hwan Park S, et al: Effect of contrast-induced nephropathy on cardiac outcomes after use of nonionic isosmolar contrast media during coronary procedure. J Cardiol 2010;56:300-306.
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