Association Between Epicardial Adipose Tissue and Contrast-Induced Acute Kidney Injury in Patients with ST-Segment Elevation Myocardial Infarction.

Background: Epicardial adipose tissue (EAT) affects the kidneys by secreting various bioactive molecules. Contrast-induced acute kidney injury (CI-AKI) is a common complication after percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) patients. The relationship between EAT and CI-AKI remains unclear. This study aims to explore the relationship between EAT and the incidence of CI-AKI after PCI in STEMI patients.

Methods: Patients diagnosed with STEMI were continuously included, all patients underwent PCI within 12 hours of onset. EAT volume was measured and obtained by chest CT. Logistic regression analysis was used to analyze possible risk factors for CI-AKI. Restricted cubic splines (RCS) were utilized to explore the dose-response relationship involving EAT and CI-AKI.

Results: The incidence of CI-AKI was 8.9% (57/638). Compared with the Non-CI-AKI group, the EAT volume was significantly higher (p<0.005). After adjusting for confounding factors, multivariate regression analysis showed FBG, NT-proBNP, LVEF, and EAT volume were the independent predictors for CI-AKI. RCS analysis indicated a linear dose-response relationship between EAT volume and CI-AKI. The integration of EAT volume could significantly improve ability of the model for CI-AKI (NRI 0.4071, 95% CI 0.231 ~ 0.583, p < 0.001; IDI 0.1356, 95% CI 0.091 ~ 0.180, p < 0.001).

Conclusion: Higher EAT volume was an independent risk factor for CI-AKI in STEMI patients. Integration of EAT volume could significantly improve the risk model for CI-AKI.