Predictive Value of Fibrinogen-to-Albumin Ratio for Post-Contrast Acute Kidney Injury in Patients Undergoing Elective Percutaneous Coronary Intervention

Background: Post-contrast acute kidney injury (PC-AKI) is a contributor to adverse outcomes after percutaneous coronary intervention (PCI). This study aimed to investigate whether fibrinogen-to-albumin ratio (FAR), a novel inflammation-based risk index, can predict the occurrence of PC-AKI in patients undergoing elective PCI. Material/Methods: We retrospectively enrolled 291 patients who underwent elective PCI from June 2017 to June 2019. PC-AKI was defined as an increase in serum creatinine >= 0.3 mg/dL (>= 26.5 mu mol/L), or >= 1.5 times baseline within 48 to 72 hours after PCI. The area under the receiver-operating characteristic curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to make comparison for PC-AKI prediction. Results: PC-AKI occurred in 43 patients (14.8%). FAR showed an AUC of 0.691 (95% confidence interval: 0.64-0.74; P<0.001) in predicting PC-AKI. In stepwise multivariable logistic regression, FAR was independently associated with the occurrence of PC-AKI along with hypertension, diabetes, hemoglobin, estimated glomerular filtration rate, and left ventricular ejection fraction. FAR significantly improved PC-AKI prediction over Mehran risk score in the continuous NRI and IDI, but not AUC. Conclusions: FAR is independently associated with the occurrence of PC-AKI, and can significantly improve PC-AKI prediction over Mehran risk score in patients undergoing elective PCI.