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. 2024 Feb;47(2):e24219.
doi: 10.1002/clc.24219.

Lactate dehydrogenase-to-albumin ratio: A superior inflammatory marker for predicting contrast-associated acute kidney injury after percutaneous coronary intervention

Ji-Lang Zeng  1   2   3 , Jun-Han Chen  1   2   3 , Li-Wei Zhang  1   2   3 , Li-Chuan Chen  1   2   3 , Wen-Jia Liang  1   2   3 , Zhebin You  2   3   4 , Kai-Yang Lin  1   2   3 , Yansong Guo  1   2   3
Affiliations

Lactate dehydrogenase-to-albumin ratio: A superior inflammatory marker for predicting contrast-associated acute kidney injury after percutaneous coronary intervention

Ji-Lang Zeng et al. Clin Cardiol. 2024 Feb.

Abstract

Purpose: Inflammation is commonly considered a mechanism underlying contrast-associated acute kidney injury (CA-AKI). This study aimed to explore the predictive capability of the novel inflammatory marker lactate dehydrogenase-to-albumin ratio (LAR) for CA-AKI following percutaneous coronary intervention (PCI), and further compare it with other common inflammatory biomarkers.

Methods: This study enrolled 5,435 patients undergoing elective PCI. The primary outcome was CA-AKI, and the secondary outcome was all-cause mortality. All patients were grouped into three groups based on the LAR tertiles.

Results: Three hundred fifteen patients (5.8%) experienced CA-AKI during hospitalization. The fully adjusted logistic regression suggested a significant increase in the risk of CA-AKI in LAR Tertile 3 (odds ratio [OR]: 2.51, 95% confidence interval [CI]: 1.68-3.83, p < .001) and Tertile 2 (OR: 2.11, 95% CI: 1.42-3.20, p < .001) compared to Tertile 1. Additionally, receiver operating characteristic (ROC) analysis demonstrated that LAR exhibited significantly superior predictive capability for CA-AKI compared to other inflammatory biomarkers. Regarding the secondary outcome, multivariate COX regression analysis showed a positive correlation between elevated LAR levels and all-cause mortality.

Conclusion: In patients undergoing elective PCI, LAR was significantly independently associated with CA-AKI, and it stood out as the optimal inflammatory biomarker for predicting CA-AKI.

Keywords: all-cause mortality; contrast-associated acute kidney injury; lactate dehydrogenase-to-albumin ratio; percutaneous coronary intervention.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Comparison of the predictive abilities of LAR, LDH, and albumin for CA‐AKI; (B) Comparison of predictive abilities for CA‐AKI among LAR and other inflammatory markers. CA‐AKI, contrast‐associated acute kidney injury; LAR, lactate dehydrogenase‐to‐albumin ratio; LDH, lactate dehydrogenase; Other abbreviations were shown in Table 1.
Figure 2
Figure 2
(A) dose–response relationship between LAR and the risk of CA‐AKI; (B) dose–response relationship between LAR and the risk of all‐cause mortality. The blue shaded area represents the 95% confidence interval. CA‐AKI, contrast‐associated acute kidney injury; LAR, lactate dehydrogenase‐to‐albumin ratio; Other abbreviations were shown in Table 1.
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