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Background: Coronary artery disease (CAD) is associated with persistent inflammation, which plays an important role in the development of renal dysfunction. This study investigated the association between composite inflammatory indices and the long-term risk of chronic kidney disease (CKD) in patients with CAD, and further aimed to identify the inflammatory marker with the best predictive performance. Methods: We included 5181 patients with CAD from three centers. Multivariable-adjusted Cox regression models and cumulative risk curves (CRC) were used to evaluate the associations between four composite inflammatory markers-aggregate index of systemic inflammation (AISI), systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and platelet-to-lymphocyte ratio (PLR)-and CKD risk. Restricted cubic splines (RCS) were applied to examine dose-response relationships, while predictive performance was compared using receiver operating characteristic (ROC) analysis, the C-index, and random forest (RF) variable importance. Results: Multivariable Cox regression showed that all four inflammatory markers were significantly associated with an increased risk of CKD, and these findings were further supported by CRC analysis. RCS analysis demonstrated clear dose-response relationships, with risk thresholds identified at AISI >115, SIRI >0.96, SII >458, and PLR >123. Among all markers, AISI showed the best predictive performance according to the combined evaluation of ROC analysis, the C-index, and RF variable importance. Conclusion: Elevated inflammatory marker levels were significantly associated with a higher risk of CKD in patients with CAD. Among the markers evaluated, AISI demonstrated the strongest predictive value and may serve as a useful indicator for early risk stratification and clinical management of CKD in this population.
Yu et al. (Thu,) studied this question.