ArticleFrontiers in cardiovascular medicine2026
Combined C-reactive protein, procalcitonin, and microalbuminuria panel for contrast-induced nephropathy risk stratification after percutaneous coronary intervention.
Article in Frontiers in cardiovascular medicine, 2026. 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
Background: Cancer patients with cardiovascular comorbidities requiring contrast-based cardiac procedures face substantially amplified risk for contrast-induced nephropathy (CIN), driven by anticancer therapy-related systemic inflammation, nephrotoxicity, and endothelial dysfunction. Validated biomarker-based risk stratification tools that capture these distinct pathophysiologic mechanisms are urgently needed in cancer cardiology practice. This study evaluated the combined predictive value of C-reactive protein (CRP), procalcitonin (PCT), and microalbuminuria (MAU) for CIN development following percutaneous coronary intervention (PCI), with direct implications for cardio-oncology risk stratification. Methods: We retrospectively analyzed 486 consecutive patients undergoing elective or urgent PCI between March 2021 and November 2024. Baseline CRP, PCT, and MAU were measured within 24 h pre-procedure. CIN was defined as serum creatinine increase ≥0.5 mg/dL or ≥25% from baseline within 48-72 h post-contrast. Results: CIN developed in 92 patients (18.9%). All three biomarkers independently predicted CIN in multivariable analysis: CRP >10 mg/L (OR = 3.15, Conclusion: Combined pre-procedural assessment of CRP, PCT, and MAU provided excellent discriminatory ability (AUC=0.856) for CIN prediction, substantially superior to individual biomarkers and traditional clinical risk factors. These complementary markers-capturing systemic inflammation, acute inflammatory stress, and baseline renal endothelial integrity, respectively-offer a clinically practical framework for biomarker-guided risk stratification in a general PCI population. As patients on active systemic anticancer therapy were excluded and patients with a cancer history comprised only a minority of the cohort, the potential extension of this panel to cardio-oncology practice is proposed as a mechanistically motivated hypothesis that requires dedicated validation rather than as a demonstrated application.
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