J-shaped relationship between creatinine levels and the risk of three major adverse events in patients after percutaneous coronary intervention.
To evaluate the correlation between creatinine (Cre) level and the risk of three kinds of adverse events in patients after percutaneous coronary intervention (PCI), and to clarify its potential correlation threshold and independent predictive value.
This investigation was designed as a retrospective cohort analysis, encompassing 3, 878 individuals diagnosed with acute myocardial infarction who received PCI between January 2018 and December 2020. The primary outcomes were three types of adverse events that occurred post-procedure. To explore the relationship between Cre levels and the outcome measures, a restricted cubic spline model was employed, while the Cox proportional hazards regression model assessed the independent predictive significance. There were 996 instances (25.7%) of adverse events reported. The evaluation using a restricted cubic spline model revealed a notable J-shaped relationship between creatinine levels and the likelihood of three types of adverse events following PCI (nonlinear P < 0.05), with the inflection point identified at 110 μmol/L. When considering Cre=110 μmol/L as the baseline, patients with Cre levels below this threshold (low value group) exhibited a 15.5% increase in MACE risk (95% CI: 1.006-1.327, P = 0.0416), a 15.6% increase in NACE risk (95% CI: 1.004-1.330, P = 0.0436) and a 16.1% increase in MACCE risk (95% CI: 1.015-1.329, P = 0.0301).
There is a J-shaped correlation between Cre level and the risk of three kinds of adverse events in patients after PCI, and the inflection point of 110 μmol/L can be used as the key threshold for clinical risk stratification and individualized intervention.
This investigation was designed as a retrospective cohort analysis, encompassing 3, 878 individuals diagnosed with acute myocardial infarction who received PCI between January 2018 and December 2020. The primary outcomes were three types of adverse events that occurred post-procedure. To explore the relationship between Cre levels and the outcome measures, a restricted cubic spline model was employed, while the Cox proportional hazards regression model assessed the independent predictive significance. There were 996 instances (25.7%) of adverse events reported. The evaluation using a restricted cubic spline model revealed a notable J-shaped relationship between creatinine levels and the likelihood of three types of adverse events following PCI (nonlinear P < 0.05), with the inflection point identified at 110 μmol/L. When considering Cre=110 μmol/L as the baseline, patients with Cre levels below this threshold (low value group) exhibited a 15.5% increase in MACE risk (95% CI: 1.006-1.327, P = 0.0416), a 15.6% increase in NACE risk (95% CI: 1.004-1.330, P = 0.0436) and a 16.1% increase in MACCE risk (95% CI: 1.015-1.329, P = 0.0301).
There is a J-shaped correlation between Cre level and the risk of three kinds of adverse events in patients after PCI, and the inflection point of 110 μmol/L can be used as the key threshold for clinical risk stratification and individualized intervention.