title: C-reactive protein and the risk of contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention.
abstract: BACKGROUND
  The relationship between preprocedural C-reactive protein (CRP) levels and the incidence of contrast-induced acute kidney injury (CI-AKI) is unknown.
  
  
  METHODS
  Documents of 7,310 consecutive patients undergoing percutaneous coronary intervention (PCI) were screened. Patients with acute myocardial infarction, cardiogenic shock, concomitant inflammatory conditions or undergoing CABG within 48 h were excluded due to potential confounding effects.
  
  
  RESULTS
  A total of 4,522 patients were valid for analysis. The median follow-up was 26 months (interquartile range 20-33 months). According to preprocedural CRP values, patients were divided into 3 groups: group 1: CRP <1.0 mg/l (n = 1,523); group 2: 1.0 mg/l ≤ CRP ≤ 3.0 mg/l (n = 1,626); group 3: CRP >3.0 mg/l (n = 1,373). Patients with higher preprocedural CRP levels were associated with a significantly increased rate of CI-AKI (10.6 vs. 14.9 vs. 23.5%, p < 0.0001). After adjustment for baseline covariates, CRP level was still an independent predictor for the incidence of CI-AKI, either as a continuous variable or a categorical variable. Patients with higher CRP values had a significantly higher rate of all-cause mortality and myocardial infarction during follow-up.
  
  
  CONCLUSIONS
  Elevated preprocedural CRP is associated with an increased risk for CI-AKI in patients undergoing PCI. Preprocedural risk stratification with CRP as an adjunct to established clinical risk factors might be useful.
authors.affiliation: Department of Cardiology, An Zhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.forename: Yu Jie
authors.initials: YJ
authors.lastname: Zhou
authors.forename: Xi
authors.initials: X
authors.lastname: Zhu
authors.forename: Zhi Jian
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Shi Wei
authors.initials: SW
authors.lastname: Yang
authors.forename: Hua
authors.initials: H
authors.lastname: Shen
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D002097:C-Reactive Protein