THE ROLE OF THE BUN-TO-ALBUMIN RATIO IN PREDICTING CONTRAST-INDUCED NEPHROPATHY AFTER PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH NSTEMI

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Abstract
Objective: Contrast-induced nephropathy (CIN) remains a common complication after percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). The BUN-to-albumin ratio (BAR) has recently emerged as a composite biomarker reflecting inflammation, renal function, and nutritional status. To evaluate the predictive value of BAR for CIN in NSTEMI patients undergoing PCI.Material and Methods: This retrospective study included 1,540 NSTEMI patients treated with PCI between 2020 and 2024. Patients were divided into CIN (+) and CIN (-) groups. Clinical, laboratory, and procedural variables were analyzed. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify independent predictors and assess discriminative performance.Results: CIN developed in 204 patients (13.2%). BAR was significantly higher in the CIN group (5.2±1.5 vs. 4.0±1.2, p<0.001). In multivariate analysis, BAR emerged as an independent predictor of CIN (OR: 1.943, 95% CI: 1.703-2.217, p<0.001). ROC analysis showed that BAR had the highest discriminative ability (AUC: 0.726), outperforming NLR (AUC: 0.654) and the Mehran score (AUC: 0.599). A cut-off value of 4.5 yielded 69.1% sensitivity and 63.8% specificity.Conclusion: BAR is a simple, inexpensive, and effective predictor of CIN in NSTEMI patients undergoing PCI and may serve as a practical tool for risk stratification in clinical practice.
Funding Information
  • No funding was received for this study

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