Novel Inflammatory Biomarkers Are Associated with Contrast-Induced Acute Kidney Injury in Elderly Patients with St-Segment Elevation Myocardial Infarction

Background: The inflammatory response is critically important in ST-segment elevation myocardial infarction (STEMI). Systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), which are novel inflammatory biomarkers, have been linked to determining outcomes in various diseases. The aim of the current study was to examine the relation of the SII index and SIRI with contrast-induced acute kidney injury (CI-AKI) in elderly subjects with (STEMI) undergoing primary percutaneous coronary intervention (pPCI). Methods: All patients diagnosed with STEMI between November 2020 and September 2024 were screened, and patients aged over 70 were retrospectively analyzed in the present study. The patients were divided into 2 groups according to CI-AKI development. SII and SIRI were calculated based on peripheral blood counts. A receiver operating characteristic (ROC) curve analysis was performed to determine the sensitivity and specificity of SII and SIRI in predicting CI-AKI. Additionally, multivariable logistic regression models were employed to investigate the associations between inflammatory indices and the incidence of CI-AKI in elderly patients with STEMI. Results: A total of 263 participants were included (mean age 77,67±6,20, 56% women). Both SII and SIRI were higher in the CI-AKI group than in the non-CI-AKI group (3252±2257, 1097±991 p< .001 for SII; 12,1±4,54, 4,86±2,42 p< .006 for SIRI). In the receiver operating characteristic analysis, SII and SIRI showed the highest area under curve (AUC) compared with other inflammatory parameters. The AUC of SII and SIRI were 0.903 and 0.867, the sensitivity and specificity were 80.1% and 84.4%, 77.5% and 81.0% respectively (p< .001, p< .001). In multivariate logistic regression analysis, SII (odds ratio (OR): OR: 1.114, 95% CI: 1.050–1.183, p = .001), and SIRI (OR: 1.23, 95% CI: 1.057–1.433, p = .008) were associated with CI-AKI. Conclusions: SII and SIRI were found to be important markers for predicting post-procedural CI-AKI in elderly patients with STEMI.