Pre-Procedural Lpa level and ApoB/ApoA1 Ratio and the Risk for Contrast-Induced Acute Kidney Injury in Patients Undergoing Emergency Percutaneous Coronary Intervention

Abstract Background: High serum Lpa level and ApoB/ApoA1 ratio are risk factors for cardiovascular disease and kidney disease, and have been found to be related to the prevalence and prognosis of a variety of kidney diseases. However, it is not clear whether the preoperative serum Lpa level and ApoB/ApoA1 ratio are related to the incidence of CI-AKI after PCI.Methods: The 931 patients who underwent emergency PCI surgery from July 2018 to July 2020 were included. According to whether the serum creatinine level was higher than the baseline level (≥25% or ≥0.5 mg/dL) 48-72 hours after PCI, these participants were divided into CI-AKI group (n=174) and non-CI-AKI group(n=757). We detected the serum Lpa, ApoA1 and ApoB levels of the patients when they were admitted to the hospital, and calculated ApoB/ApoA1. Logistic regression and restricted cubic spline analyses were used to determine the correlation between Lpa concentration and ApoB/ApoA1 ratio and the risk of CI-AKI.Results: Among 931 patients undergoing emergency PCI, 174 (18.69%) patients developed CI-AKI. The preoperative Lpa level and ApoB/ApoA1 ratio of the CI-AKI group were higher than those of the non-CI-AKI group, and the differences were statistically significant (P <0.05). In each logistic regression model, we found that preoperative serum Lpa level and ApoB / ApoA1 ratio were inversely associated with the incidence of CI-AKI(P <0.05). After adjusting all the risk factors included in this study, restricted cubic spline analyses found that the preoperative Lpa level and the ApoB/ApoA1 ratio were positively correlated with the incidence of CI-AKI within a certain range.Conclusion: The preoperative high levels of Lpa and the ratio of ApoB/ApoA1 are independent risk factors for the onset of CI-AKI.