ArticleRenal failure2025
Nomogram for predicting acute kidney injury after primary PCI in STEMI patients: development and validation study.
Article in Renal failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo identify the risk factors for acute kidney injury (AKI) after primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) and to develop and evaluate a nomogram predictive model.
methodsA retrospective analysis was performed on STEMI patients who underwent primary PCI in our hospital between January 1, 2020, and December 31, 2024. Patients were divided into AKI and non-AKI groups. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors for post-PCI AKI. Based on these factors, a nomogram model was constructed and its predictive accuracy, calibration, and clinical utility were assessed using receiver operating characteristic (ROC) curve analysis, calibration curves, and decision curve analysis (DCA).
resultsA total of 227 STEMI patients were enrolled, of whom 41 (18.1%) developed AKI after PCI. NSAIDs use, female sex, blood glucose, serum creatinine, and serum uric acid emerged as independent risk factors. The ROC analysis showed that the nomogram model (AUC: 0.793) had superior predictive performance compared to the Mehran score (AUC: 0.626). Calibration plots showed strong alignment between predicted and observed outcomes, while DCA indicated a substantial net benefit. Moreover, patients in the high-risk group had significantly longer lengths of stays than those in the low- and moderate-risk groups.
conclusionThe nomogram model exhibits robust predictive accuracy and clinical utility, providing valuable support for the early identification of high-risk STEMI patients for AKI after primary PCI and facilitating the implementation of stratified preventive strategies.
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