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A Delta Neutrophil Index for the Prediction of Contrast-Induced Nephropathy in Patients With St-Elevation Myocardial Infarction Followed By Percutaneous Coronary Intervention

 Taeyoung Kong  ;  Yoo Seok Park  ;  Hye Sun Lee  ;  Sinae Kim  ;  Sehee Han  ;  Claire H Eun  ;  Jong Wook Lee  ;  Je Sung You  ;  Hyun Soo Chung  ;  Incheol Park  ;  Sung Phil Chung 
 Shock, Vol.49(3) : 317-325, 2018 
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PURPOSE: We assessed the usefulness of the delta neutrophil index (DNI), reflecting immature granulocytes, to stratify risk for developing contrast-induced nephropathy (CIN) in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) in a clinical setting. METHODS: This study retrospectively analyzed prospective data of eligible adult patients admitted to the emergency department (ED) with STEMI followed by PCI. We determined DNI at multiple time points and analyzed the development of CIN and in-hospital mortality according to CIN incidence. RESULTS: Overall, 564 patients with STEMI followed by PCI were included. Of these, 58 patients (10.3%) had CIN. Areas under the curve for predictability of CIN using the DNI within 2 h after PCI (I) and 24 h on ED admission (24) among patients with CIN were 0.775 (P < 0.001) and 0.751 (P < 0.001), respectively. Multivariable logistic regression demonstrated that increased DNI values at time I (odds ratio [OR], 1.632; 95% confidence interval [CI], 1.357-1.964; P < 0.001) and time 24 (OR, 1.503; 95% CI, 1.272-1.777; P < 0.001) were strong independent factors for predicting CIN among patients with STEMI who underwent PCI. Increasing predictability of CIN was closely associated with DNI more than 1.8% on ED admission (OR, 12.494; 95% CI, 6.540-23.87; P < 0.001) and more than 1.9% at time 24 (OR, 10.45; 95% CI, 5.769-18.928; P < 0.001). CONCLUSION: The DNI is easily obtained as part of the complete blood count measurement without requiring additional cost or time. High DNI independently predicts the development of CIN in patients with acute STEMI followed by PCI.
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
공태영(Kong, Tae Young) ORCID logo https://orcid.org/0000-0002-4182-7245
김시내(Kim, Si Nae)
박유석(Park, Yoo Seok) ORCID logo https://orcid.org/0000-0003-1543-4664
박인철(Park, In Cheol) ORCID logo https://orcid.org/0000-0001-7033-766X
유제성(You, Je Sung) ORCID logo https://orcid.org/0000-0002-2074-6745
이혜선(Lee, Hye Sun) ORCID logo https://orcid.org/0000-0001-6328-6948
정성필(Chung, Sung Pil) ORCID logo https://orcid.org/0000-0002-3074-011X
정현수(Chung, Hyun Soo) ORCID logo https://orcid.org/0000-0001-6110-1495
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