Neutrophil Percentage as a Potential Biomarker of Acute Kidney Injury Risk and Short-Term Prognosis in Patients with Acute Myocardial Infarction in the Elderly

Abstract

Objective

This study aimed to explore the association of preoperative neutrophil percentage (NEUT%) with the risk of acute kidney injury (AKI) in patients with acute myocardial infarction (AMI) having undergone coronary interventional therapy.

Methods

A single-center, retrospective and observational study was conducted. From December 2012 to June 2021, patients with AMI were enrolled and divided into AKI group and non-AKI group. The NEUT% in the two groups was compared. The association between NEUT% with the risk of post-AMI AKI was analyzed by univariate and multivariable logistic regression. Kaplan-Meier survival curve was drawn to evaluate the prognostic ability of NEUT% for short-term all-cause death following AMI.

Results

A total of 3001 consecutive patients were enrolled with an average age of 64.38 years. AKI occurred in 327 (10.9%) patients. The NEUT% was higher in the AKI group than in the non-AKI group ([76.65±11.43]% versus [73.22±11.83]%, P<0.001). NEUT% was also identified as an independent risk factor for AKI in AMI patients after adjustment (OR=1.021, 95% CI: 1.010–1.033, P < 0.001). Compared with those at the lowest quartile of NEUT%, the patients at quartiles 2–4 had a higher risk of AKI (P for trend = 0.003). The odds of AKI increased by 29.0% as NEUT% increased by 1 standard deviation (OR=1.290, 95% CI: 1.087–1.531, P = 0.004). After a median of 35 days follow-up, 93 patients died. Patients with a higher NEUT% presented a higher risk of all-cause death after AMI (Log rank: χ² =24.753, P<0.001).

Conclusion

In AMI patients, the peripheral blood NEUT% was positively associated with the odds of AKI and short-term all-cause mortality. NEUT% may provide physicians with more information about disease development and prognosis.

Keywords:

• neutrophil percentage
• acute kidney injury
• acute myocardial infarction

Disclosure

The authors declare no competing interests in this work.

Additional information

Funding

This study was supported by National Natural Science Foundation of China (Grant No.82270328), Natural Science Foundation of Jiangsu Province (BK20221229), China Postdoctoral Science Funding Program (2022M720544), Changzhou High-Level Medical Talents Training Project (2022CZBJ054, 2022CZBJ053), the Technology Development Fund of Nanjing Medical University (NMUB2020069), Major Research plan of Changzhou Health Commission of Jiangsu Province of China (ZD202215), Changzhou Sci&Tech Program (CE20225051). Major Research plan of Wannan Medical College (WK2022F19) and Major Research plan of Anhui Education Commission (KJ2021A0822).