Predictive value of serum high mobility group protein B1 for contrast-induced nephropathy in patients with acute ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

LI Yong; Su Ya-kun; Li Yuan; Zhang Hong-bo; LI Zhan-hu; YAN Xiao-ju

doi:10.3969/j.issn.1672-5301.2024.08.015

Abstract：Objective To explore the predictive value of serum high mobility group protein B1(HMGB1)level before and after primary percutaneous coronary intervention(PPCI)on the occurrence of contrast-induced nephropathy(CIN)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods The data of 235 STEMI patients who underwent primary PCI for the first time in Hengshui People's Hospital from January to December 2022 were retrospectively analyzed.The patients were divided into the CIN group and non-CIN group according to whether CIN occurred after the operation.The general clinical data,serum HMGB1,cystatin C(CysC)and creatinine(SCr)levels were compared between the two groups before and 6 h,24 h and 48-72 h after the operation.Multivariate logistic regression analysis was used to analyze the related factors of CIN after the operation.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of each index for CIN after the primary PCI.Results CIN occurred in 33 cases after the operation,with an incidence of 14.04％.Compared with the non-CIN group,the blood glucose(ABG),glycosylated hemoglobin(HbAlC)and contrast agent dosage were significantly increased in the CIN group[(9.66±3.49)mmol/L vs.(7.85±2.35)mmol/L、(15.08±4.33)％vs.(13.10±5.12)％、(124.03±13.87)ml vs.(118.81±11.74)ml],and the neutrophil/lymphocyte ratio(NLR),previous history of kidney disease and heart failure were also higher(all P＜0.05).The levels of serum HMGB1 and CysC in CIN group were higher than those in non-CIN group before and after operation.Serum SCr levels at 24 h and 48-72 h after operation were also higher than those in the non-CIN group(P＜0.05),but there was no signifiicant difference in serum creatinine levels between the two groups before and 6 h after operation(P＞0.05).Logistic regression analysis showed that ABG,higher levels of HMGB1 and Cys C before and 6 hours after operation were the independent risk factors for CIN after the primary PCI.ROC curve showed that the area under the curve(AUC)of predicting CIN was 0.974(95％CI 0.947-1.000)and 0.964(95％CI 0.934-0.995)at 6 h after operation and preoperative serum HMGB1 level,respectively.The specificity of serum HMGB1 at 6 h after the operation was the highest.Conclusion The HMGB1 level at 6 h after PPCI and before PPCI in STEMI patients has a good predictive value for predicting the occurrence of CIN after PPCI,and the predictive value of HMGB1 level change at 6 h after PPCI is better.