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. 2024 Dec 19:11:1430215.
doi: 10.3389/fcvm.2024.1430215. eCollection 2024.

Prognostic potential of inflammatory markers in chronic kidney disease patients combined with acute myocardial infarction

Peizhu Dang #  1 , Bohan Li #  1 , Yongxin Li  2
Affiliations

Prognostic potential of inflammatory markers in chronic kidney disease patients combined with acute myocardial infarction

Peizhu Dang et al. Front Cardiovasc Med. .

Abstract

Background: Inflammation significantly impacts chronic kidney disease (CKD) and acute myocardial infarction (AMI). This study investigates the prognostic value of inflammatory markers in predicting outcomes for CKD patients with AMI.

Methods: We enrolled patients diagnosed with CKD concomitant with AMI, choosing five inflammatory markers related to both diseases. Patients were categorized into elevated inflammatory markers group and control group based on inflammatory markers cut-off values for predicting in-hospital major adverse cardiac and cerebrovascular events (MACCE). Using univariate and multivariate logistic regression, we identified inflammation-related risk factors for MACCE. We adjusted covariates stepwise to explore the relationship between independent risk factors and adverse outcomes. We also evaluated the predictive value of these markers for MACCE by receiver operating characteristic (ROC) curves.

Results: In the multivariate logistic regression analysis, higher levels of neutrophil-to-lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) significantly increased risk of MACCE (all P < 0.05). After adjusting above two indicators, NLR was independently associated with in-hospital MACCE in CKD patients with AMI (OR = 10.764, 95% CI: 1.887-61.406, P = 0.007). Furthermore, compared to other inflammatory markers, NLR had the highest predictive value for MACCE in patients with AMI and CKD [Area Under the Curve (AUC): 0.748, 95% Confidence Interval (CI): 0.634-0.861, P < 0.001].

Conclusion: In CKD patients combined with AMI, elevated levels of inflammation markers could increase the risk of MACCE. NLR may provide superior predictive value compared to other markers.

Keywords: acute myocardial infarction; chronic kidney disease; inflammatory markers; neutrophil-to-lymphocyte ratio; prognosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study protocol. The flowchart of enrollment of study patients. CKD, chronic kidney disease; AMI, acute myocardial infarction; NLR, neutrophil to lymphocyte ratio; PLR, platelet to lymphocyte ratio; FIB, fibrinogen; ALB, albumin; hs-CRP, high-sensitivity C-reactive protein; MACCE, major adverse cardiac and cerebrovascular events.
Figure 2
Figure 2
Association between NLR and MACCE in all patients. Model 1: unadjusted model; Model 2: adjusted for age and sex; Model 3: adjusted for age, sex, comorbidities (hypertension, diabetes, valvular disease, smoking history), cardiac function, coronary angiography results, and laboratory data. NLR, neutrophil-to-lymphocyte ratio; OR, odd ratio; CI, confidence interval; MACCE, major adverse cardiac and cerebrovascular events.
Figure 3
Figure 3
ROC curves for predicting MACCE in all patients. ROC curves for predicting MACCE plotted by the NLR in CKD patients combined with AMI. ROC, receiver operating characteristic; NLR, neutrophil-to-lymphocyte ratio; CKD, chronic kidney disease; AMI, acute myocardial infarction; MACCE, major adverse cardiac and cerebrovascular events.
Figure 4
Figure 4
Nomogram for predicting MACCE in all patients.
See this image and copyright information in PMC

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