术前NLR、D-D及CACS构建PCI术后CIN预测模型OA

Aim To analyze the predictive value of preoperative neutrophil-to-lymphocyte ratio(NLR),D-dimer(D-D),and coronary artery calcium score(CACS)for contrast induced nephropathy(CIN)after percutaneous coronary intervention(PCI),and to construct a postoperative CIN prediction model.Methods A total of 426 patients with coronary artery disease who under-went PCI were selected and divided into a training set(n=298)and a validation set(n=128)at a ratio of 7∶3.Based on the oc-currence of CIN postoperatively,the training set cases were categorized into a CIN group(n=57)and a non-CIN group(n=241).Clinical data were compared among different groups.Logistic multivariate regression analysis was employed to identify predictors of CIN and construct a predictive model.The predictive performance and stratification value of the model were evaluated using ROC curves and calibration curves.Results There was a significant difference in age,proportion of diabetes,left ventricular ejection fraction,preoperative creatinine,estimated glomerular filtration rate,contrast agent dosage,proportion of diuretic use,white blood cell count,neutrophil count,lymphocyte count,NLR,the levels of D-D,fasting blood glucose,and CACS score,between the CIN group and the non-CIN group(P<0.05).NLR,D-D,and CACS were influencing factors for postoperative CIN(P<0.001).A predic-tive model for post-PCI CIN was successfully established,with the model's AUC significantly higher than that of any single indicator(P<0.001).Conclusion A predictive model for post-PCI CIN based on preoperative NLR,D-D,and CACS was successfully constructed and validated.The model demonstrated excellent predictive performance and clear stratification capability,providing ro-bust evidence for early clinical identification of high-risk patients and implementation of targeted interventions.