The following is a summary of “Comparison of cardiac biomarkers on risk assessment of contrast-associated acute kidney injury in patients undergoing cardiac catheterization: A multicenter retrospective study,” published in the August 2023 issue of Nephrology by Yu et al.

The predictive value of cardiac biomarkers for contrast-associated acute kidney injury (CA-AKI) is still unclear. Researchers analyzed the association between preoperative creatine kinase isoenzyme-MB (CKMB), cardiac troponin I (cTnI), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and CA-AKI in patients undergoing cardiac catheterization.

They analyzed 3,553 individuals who had undergone cardiac catheterization. CA-AKI rises in serum creatinine ≥ 0.3 mg/dL or >50% from baseline (48 hours) of cardiac catheterization. Logistic regression models and receiver operating characteristic (ROC) curves were employed to assess the relationship between cardiac biomarkers and CA-AKI, as well as the effectiveness of the Mehran risk score (MRS) model in predicting CA-AKI, both with and without the inclusion of cardiac biomarkers.

The results showed 3,553 individuals, 200 (5.63%) developed CA-AKI. The logistic regression model identified log₁₀CKMB (OR: 1.97, 95% CI: 1.51–2.57, P<.001), cTnI (OR: 1.03, 95%CI: 1.02–1.04, P<.001), and log₁₀NT-proBNP (OR: 3.19, 95%CI: 2.46–4.17, P<.001) as independent CA-AKI predictors. The ROC curve showed that the area below the curve (AUC) for MRS was 0.733. Combining CKMB, cTnI, and NT-proBNP with the MRS model increased the AUC value (NT-proBNP: 0.798, P<.001; CKMB: 0.758, P=.003; cTnI: 0.755, P=.002), with NT-proBNP offering the most substantial predictive improvement.

They concluded that Cardiac biomarkers can predict CA-AKI in cardiac catheterization patients, with NT-proBNP being the most accurate.

Source: onlinelibrary.wiley.com/doi/10.1111/nep.14233