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Creatinine levels show J-shaped association with adverse events after PCI for myocardial infarction.

Creatinine levels show J-shaped association with adverse events after PCI for myocardial infarction.
Photo by Brett Jordan / Unsplash
Key Takeaway
Consider the J-shaped association between creatinine and post-PCI adverse events as observational, not causal.

This was a retrospective cohort analysis of 3,878 patients diagnosed with acute myocardial infarction who received percutaneous coronary intervention (PCI). The study examined creatinine levels as an exposure, but the comparator was not reported. The primary outcome was three types of adverse events that occurred post-procedure.

The main result was a J-shaped relationship between creatinine levels and the likelihood of the three adverse events, with a nonlinear P value of < 0.001. There were 996 instances (25.7%) of adverse events reported. The effect size was not reported.

Safety and tolerability data were not reported, including adverse events, serious adverse events, and discontinuations. The follow-up duration was not reported.

Key limitations include the observational design, which cannot establish causation, and the lack of a comparator group. The study does not report specific creatinine thresholds or independent predictive values beyond the J-shaped relationship.

Practice relevance is not reported. The findings suggest an association between creatinine levels and post-PCI adverse events in this population, but clinical application requires caution due to the study's design and missing details.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
Background and aimsTo 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.Methods and resultsThis 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 
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