Association Between Uric Acid-to-Albumin Ratio and Contrast-Induced Nephropathy and Mortality: An Evaluation in Chronic Total Occlusion Cases

OpenAlex · İngilizce

Objectives: Among individuals undergoing coronary angiography (CAG), chronic coronary total occlusion (CTO) represents a prevalent lesion type that often requires treatment with percutaneous coronary intervention (PCI). Following PCI, contrast-induced nephropathy (CIN) represents a frequent complication that contributes to elevated morbidity and mortality. The uric acid-to-albumin ratio (UAR) has recently been identified as a novel biomarker linked to unfavorable clinical outcomes. This investigation sought to determine the prognostic significance of UAR for CIN and long-term mortality in CTO patients. Methods: A total of 169 patients managed with PCI for one or more CTO lesions were retrospectively evaluated. Patients were then categorized according to the development of CIN into two groups: CIN-positive (n = 27) and CIN-negative (n = 142). Results: The CIN (+) group demonstrated significantly elevated serum uric acid levels, higher UAR values, and increased mortality rates compared with the CIN (−) group (all p < 0.001). Further multivariate regression analysis established UAR as an autonomous prognostic indicator of CIN (p = 0.012). A UAR cut-off value of 1.77 predicted CIN with 66.7% sensitivity and 62% specificity, while a cut-off of 1.90 predicted long-term mortality with 64.5% sensitivity and 73.9% specificity. According to Kaplan–Meier survival curves, individuals in the CIN-positive group exhibited markedly lower long-term survival and a higher frequency of all-cause death (log-rank, p < 0.001). Conclusion: An increased UAR independently predicted both CIN and long-term mortality in CTO patients, underscoring its prognostic significance in this high-risk population.