NSTEMI Hastalarında Perkütan Koroner Girişim Sonrası Kontrast İlişkili Nefropatinin Öngörülmesinde BUN/Albumin Oranının Rolü

Öz

Amaç: Non-ST segment elevasyonlu miyokard enfarktüsü (NSTEMI) hastalarında perkütan koroner girişim (PKG) sonrası gelişen kontrast ilişkili nefropatinin (CIN) öngörülmesinde BUN/albümin oranının (BAR) değerini araştırmak.

Gereç ve Yöntemler: Bu retrospektif çalışmaya 2020-2024 yılları arasında PKG uygulanan 1,540 NSTEMI hastası dahil edildi. Hastalar CIN (+) ve CIN (-) olarak iki gruba ayrıldı. Klinik, laboratuvar ve anjiyografik veriler analiz edildi. Bağımsız prediktörleri belirlemek için çok değişkenli lojistik regresyon ve tanısal performansı değerlendirmek için ROC analizi yapıldı.

Bulgular: CIN, 204 hastada (%13,2) gelişti. BAR değeri CIN grubunda anlamlı derecede daha yüksekti (5,2±1,5 vs. 4,0±1,2, p<0,001). Çok değişkenli analizde BAR, CIN gelişiminin bağımsız bir belirleyicisi olarak saptandı (OR: 1,943, %95 GA: 1,703-2,217, p<0,001). ROC analizinde BAR en yüksek ayırt edici güce sahip parametreydi (AUC: 0,726) ve NLR ile Mehran skorundan daha iyi performans gösterdi.

Sonuç: BAR, NSTEMI hastalarında CIN gelişimini öngörmede basit, düşük maliyetli ve etkili bir biyobelirteç olup klinik risk sınıflandırmasında kullanılabilir.

Anahtar Kelimeler

• Kontrast İlişkili Nefropati
• BUN/Albümin Oranı
• NSTEMI
• Perkütan Koroner Girişim

Destekleyen Kurum

Bu çalışma herhangi bir kurum veya kuruluş tarafından desteklenmemiştir

Etik Beyan

Çalışma protokolü, Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüş ve yerel etik kurul tarafından onaylanmıştır (onay numarası: 2025/06-173).

Teşekkür

Bu çalışmaya katkıda bulunan tüm bireylere teşekkür ederiz. Yazarlar bu çalışma ile ilgili herhangi bir çıkar çatışması bildirmemektedir. Yazarlar bu araştırma, yazarlık ve/veya makalenin yayımlanması için herhangi bir finansal destek almamıştır.

THE ROLE OF THE BUN-TO-ALBUMIN RATIO IN PREDICTING CONTRAST-INDUCED NEPHROPATHY AFTER PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH NSTEMI

Öz

Objective: Contrast-induced nephropathy (CIN) remains a common complication after percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). The BUN-to-albumin ratio (BAR) has recently emerged as a composite biomarker reflecting inflammation, renal function, and nutritional status. To evaluate the predictive value of BAR for CIN in NSTEMI patients undergoing PCI.

Material and Methods: This retrospective study included 1,540 NSTEMI patients treated with PCI between 2020 and 2024. Patients were divided into CIN (+) and CIN (-) groups. Clinical, laboratory, and procedural variables were analyzed. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify independent predictors and assess discriminative performance.

Results: CIN developed in 204 patients (13.2%). BAR was significantly higher in the CIN group (5.2±1.5 vs. 4.0±1.2, p<0.001). In multivariate analysis, BAR emerged as an independent predictor of CIN (OR: 1.943, 95% CI: 1.703-2.217, p<0.001). ROC analysis showed that BAR had the highest discriminative ability (AUC: 0.726), outperforming NLR (AUC: 0.654) and the Mehran score (AUC: 0.599). A cut-off value of 4.5 yielded 69.1% sensitivity and 63.8% specificity.

Conclusion: BAR is a simple, inexpensive, and effective predictor of CIN in NSTEMI patients undergoing PCI and may serve as a practical tool for risk stratification in clinical practice.

Anahtar Kelimeler

• Contrast-Induced Nephropathy
• BUN-To-Albumin Ratio
• NSTEMI
• Percutaneous Coronary Intervention

Destekleyen Kurum

No funding was received for this study

Etik Beyan

The study protocol was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the local ethics committee (approval number: 2025/06-173).

Teşekkür

We express our gratitude to all individuals who contributed to this project. The authors report no conflicts of interest in this work. The authors received no financial support for the research, authorship, and/or publication of this article

Kaynakça

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