Association between Neutrophil-To-Lymphocyte ratio and incidence of contrast Induced Nephropathy among adults undergoing Percutaneous Coronary Intervention

ABSTRACT

Introduction@#Though the role of inflammation is reputedly associated with contrast induced nephropathy (CIN), especially in the setting of Acute Coronary Syndrome (ACS), current risk scoring systems do not address inflammatory factors. Neutrophil lymphocyte ratio (NLR), a proportion of two inflammatory markers, is reflective of the balance between innate and adaptive immune responses, and therefore has a strong predictive value.@*Methods@#A cross-sectional analytical study done among adult Filipinos diagnosed with ACS who underwent Percutaneous Coronary Intervention (PCI) from January to December 2018 at Makati Medical Center. Exposure of interest includes baseline NLR count and pre-procedural serum creatinine. Outcome was the incidence of CIN based on serum creatinine 24-48 hours post-procedure.@*Results and Analysis@#A total of 166 ACS patients were analyzed, of which 11 (6.62%) has CIN. Patients with pre-procedural NLR > 4.71 were approximately five times as likely to develop CIN (aOR 1.51 to 17.55, p = 0.009), with sensitivity 63.64%, specificity 80.65%, accuracy 79.52%, Youden’s index 44.29%. On multivariate analysis, NLR and STEMI were associated with increased odds for CIN. STEMI patients had approximately four times the odds of developing CIN (aOR 3.893, 95% CI 1.07 to 14.13, p = 0.039).@*Conclusion@#NLR > 4.71 in Filipinos with ACS who underwent PCI is associated with increased risk to develop CIN.