Objective To investigate the risk factors for contrast-induced nephropathy (CIN) in patients with diabetes mellitus combined with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI), and to analyze the predictive value of stress hyperglycemia index (SHI) and glycated hemoglobin (HbA1c) for CIN. Methods 102 patients with diabetes mellitus combined with AMI who underwent PCI who were admitted to our hospital from January 2019 to January 2022 were selected, and they were divided into 26 cases in the CIN group and 76 cases in the non-CIN group according to whether CIN occurred after PCI. Baseline data of patients were collected and SHI was calculated. Univariate and multivariate Logistic regression were used to analyze the influencing factors of CIN after PCI in diabetes mellitus patients combined with AMI. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of SHI and HbA1c for CIN in diabetes mellitus patients combined with AMI after PCI. Results Univariate analysis showed that CIN group was older than non-CIN group, the proportion of hypertension, Killip grade≥Ⅱ, cardiac troponin T, N-terminal proB-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), blood glucose, HbA1c, uric acid, urea nitrogen, creatinine and SHI were higher than those in the non-CIN group, the lymphocyte count, albumin and estimated glomerular filtration rate (eGFR) were lower than those in the non-CIN group (P<0.05). Multivariate Logistic regression analysis showed that increased age, hypertension, Killip grade≥Ⅱ, increased NT-proBNP, decreased albumin, increased hs-CRP, increased HbA1c, increased serum creatinine, decreased eGFR, and increased SHI were independent risk factors for CIN in patients with diabetes mellitus combined with AMI after PCI (all P<0.05). ROC curve analysis showed that the area under curve of SHI and HbA1c combined to predict CIN after PCI was greater than the area under curve of them alone. Conclusion Increase age, hypertension, Killip grade greater than or equal to Ⅱ, NT-proBNP, hs-CRP, HbA1c, serum creatinine, SHI and decrease albumin and eGFR are independent risk factors for CIN in patients with diabetes mellitus combined with AMI after PCI. SHI combined with HbA1c has a high predictive value for CIN in patients with diabetes mellitus combined with AMI after PCI. |