Serum Kidney Injury Molecule-1 and Cytochrome C as Biomarkers for Early Detection of Contrast-Induced Nephropathy in Elderly Patients with ST-Elevation Myocardial

Al Allam, Ahmed Salah Amin; Hassaan, Mohammed Mohammed Mohammed; Mohammed, Zeinab Maher; Samy, Malak Emad; Allam, Hala M.; Mahrous, Haytham Kamal Ahmed; Eldamanhory, Ahmed Said Ibrahim; Magdy, Mahmud M.

doi:10.21608/zumj.2025.349376.3770

Serum Kidney Injury Molecule-1 and Cytochrome C as Biomarkers for Early Detection of Contrast-Induced Nephropathy in Elderly Patients with ST-Elevation Myocardial

Document Type : Original Article

Authors

¹ Assistant Professor of Internal Medicine, Faculty of Medicine, Zagazig University

² Professor of Internal Medicine, Faculty of Medicine, Zagazig University

³ Lecturer of Internal Medicine, Faculty of Medicine, Zagazig University

⁴ Medical student , Faculty of Medicine, Zagazig University

⁵ Lecturer of Clinical pathology, Faculty of Medicine, Zagazig University

⁶ Assistant Professor of Cardiology, Faculty of Medicine, Zagazig University

10.21608/zumj.2025.349376.3770

Abstract

Background: Kidney Injury Molecule 1 (KIM-1) as well as cytochrome c (Cyt c) are two examples of new renal biomarkers that are demonstrating promising capabilities for early revealing of CIN. This study aimed to evaluate potential of KIM-1 Cyt c as early biomarkers for detection of CIN before creatinine in elderly patients who underwent primary percutaneous coronary intervention (PCI) following ST-elevation myocardial infarction (STEMI).

Methods: Sixty elderly patients were included in this case control study patients 40 of them with clinical, biochemical evidence of STEMI who received primary PCI treatment at cardiology Department who then classified into 3 groups: Group 1 consists of 20 healthy controls; Group 2 consists of 20 STMI patients who acquired CIN after primary PCI; Group 3 consists of 20 STMI patients who did not exhibit this complication following primary PCI. We measured the serum levels of KIM-1 Cyt c using an enzyme-linked immunosorbent assay (ELISA).

Results: Blood urea nitrogen (BUN), KIM-1, Cyt c and left ventricular ejection fraction (LVEF) were substantial predictors for CIN (p=0.003, <0.001, <0.001, <0.001 respectively). In diagnosis of CIN, a Cyt c cutoff value of >0.635 resulted in a sensitivity of 79.3%, specificity of 80%,a negative predictive value (NPV) of 89.1%. On other hand, for KIM-1, a cutoff value of >9.5 produced a sensitivity of 80%, specificity of 83%, PPV of 75%, NPV of 90%.

Conclusion: Serum cytochrome c kidney damage molecule-1 could used to predict contrast induced nephropathy before creatinine among elder patients having PCI intervention following ST-elevation myocardial infarction.

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