An Online Pre-procedural Nomogram for the Prediction of Contrast-Associated Acute Kidney Injury in Patients Undergoing Coronary Angiography

Frontiers in Medicine

Menghan Gao¹  Hangpan Jiang³  Xinrui Yang⁴  Wenbin Zhang⁵  Maoning Lin⁵  Guosheng Fu⁵  Dongwu Lai⁵  Zhezhe Chen⁵  Duanbin Li⁵ 

[1] College of Medicine, Zhejiang University, Hangzhou, China;Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China;Department of Cardiology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, China;Department of Cardiology, The Hangzhou Lin’an People’s Hospital, Hangzhou, China;Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China;

关键词: contrast-associated acute kidney injury;    nomogram;    coronary artery disease;    coronary angiography;    percutaneous coronary intervention;   

DOI  :  10.3389/fmed.2022.839856

来源: DOAJ

【 摘 要 】

BackgroundIdentifying high-risk patients for contrast-associated acute kidney injury (CA-AKI) helps to take early preventive interventions. The current study aimed to establish and validate an online pre-procedural nomogram for CA-AKI in patients undergoing coronary angiography (CAG).MethodsIn this retrospective dataset, 4,295 patients undergoing CAG were enrolled and randomized into the training or testing dataset with a split ratio of 8:2. Optimal predictors for CA-AKI were determined by Least Absolute Shrinkage and Selection Operator (LASSO) and Random Forest (RF) algorithm. Nomogram was developed and deployed online. The discrimination and accuracy of the nomogram were evaluated by receiver operating characteristic (ROC) and calibration analysis, respectively. Clinical usefulness was estimated by decision curve analysis (DCA) and clinical impact curve (CIC).ResultsA total of 755 patients (17.1%) was diagnosed with CA-AKI. 7 pre-procedural predictors were identified and integrated into the nomogram, including age, gender, hemoglobin, N-terminal of the prohormone brain natriuretic peptide, neutrophil-to-lymphocyte ratio, cardiac troponin I, and loop diuretics use. The ROC analyses showed that the nomogram had a good discrimination performance for CA-AKI in the training dataset (area under the curve, AUC = 0.766, 95%CI [0.737 to 0.794]) and testing dataset (AUC = 0.737, 95%CI [0.693 to 0.780]). The nomogram was also well-calibrated in both the training dataset (P = 0.965) and the testing dataset (P = 0.789). Good clinical usefulness was identified by DCA and CIC. Finally, this model was deployed in a web server for public use (https://duanbin-li.shinyapps.io/DynNomapp/).ConclusionAn easy-to-use pre-procedural nomogram for predicting CA-AKI was established and validated in patients undergoing CAG, which was also deployed online.

【 授权许可】

Unknown