Association of Serum Uric Acid and CRP/Albumin Ratio With Contrast-Induced Nephropathy in Acute Myocardial Infarction Patients

Abstract

Contrast-induced nephropathy (CIN) significantly increases morbidity and mortality among acute myocardial infarction (MI) patients undergoing coronary angiography (CAG). This study evaluated the predictive value of serum uric acid (SUA) and C-reactive protein/albumin ratio (CAR) for CIN development. A retrospective analysis included 1326 acute MI patients who underwent CAG between November 2022 and January 2024. CIN occurred in 119 patients (9.0%). Higher SUA (5.60 vs 4.60 mg/dL, P < .001) and CAR (2.79 vs 2.15, P = .004) were significantly associated with CIN. Multivariate analysis confirmed SUA (Odds Ratio [OR]: 1.577, P < .001) and contrast volume (OR: 1.014, P < .001) as independent predictors. Receiver Operating Characteristic (ROC) analysis identified optimal SUA cutoff at 4.9 mg/dL (sensitivity 67.7%, specificity 68.1%). The predictive value of SUA was stronger among diabetic patients. Additionally, SUA positively correlated with CAR (r = .41, P < .001). A simplified risk score incorporating SUA, CAR, contrast volume, diabetes, and age effectively stratified CIN risk. Elevated SUA levels and high CAR independently predict CIN in acute MI patients, enhancing clinical risk stratification and guiding preventive strategies.