Combined Use of Pan-Immune-Inflammation Value and Triglyceride-Glucose Index for Risk Prediction of Contrast-Induced Nephropathy After Coronary Angiography in Patients with STEMI

Abstract Aim The pan-immune-inflammation value (PIV) and triglyceride-glucose (TyG) index are very important parameters that predict contrast-induced nephropathy (CIN) well in patients with ST-elevation myocardial infarction (STEMI) underwent percutaneous coronary intervention (PCI). There are limited data on the predictive value of CIN derived from the combination of PIV and TyG index compared to the use of PIV and CIN alone in patients with STEMI who underwent PCI. We aimed to evaluate the ability of the combination of PIV and TyG index, routinely obtained on admission, to identify STEMI patients at risk of CIN. Method Between 2018 and 2024, 2367 patients with STEMI who underwent PCI were included. CIN was defined as a 25% or 0.5 mg/dL increase in creatinine from baseline within 48–72 h after PCI. Receiver operating curve (ROC) analysis was performed to predict the development of CIN. Results In ROC analysis, the cut-off values of PIV and TyG index for best predicting CIN were 548, and 8.97 respectively. The combination of two markers was the most powerful predictor of CIN risk when included in a single variable such as high PIV or high TyG index. Furthermore, the co-presence of high PIV and high TyG index exhibited the highest specificity for CIN(82%) compared to high PIV(77%) or TyG index(71%) alone. Conclusion The combination of PIV and TyG index, a simple and cost-effective risk assessment, may be a more reliable prognostic indicator for predicting the development of CIN in STEMI patients undergoing PCI than the use of PIV and TyG index alone.