Pre-operative kidney biomarkers and risks for death, cardiovascular and chronic kidney disease events after cardiac surgery: the TRIBE-AKI study.
Pre-operative kidney biomarkers and risks for death, cardiovascular and chronic kidney disease events after cardiac surgery: the TRIBE-AKI study.
复制标题
心脏手术后的术前肾脏生物标志物和死亡，心血管和慢性肾脏疾病事件的风险：Tribe-Aki研究。
DOI：
10.1186/s13019-022-02066-4
复制
发表时间：
2022-12-25
影响因子：
1.6
通讯作者：
Coca, Steven G.
中科院分区：
文献类型：
--
作者：
Vasquez-Rios, George;Moledina, Dennis G.;Jia, Yaqi;McArthur, Eric;Mansour, Sherry G.;Thiessen-Philbrook, Heather;Shlipak, Michael G.;Koyner, Jay L.;Garg, Amit X.;Parikh, Chirag R.;Coca, Steven G.
可溶性肿瘤坏死因子受体（sTNFR）1、sTNFR 2和血浆肾损伤分子-1（KIM-1）与糖尿病和非糖尿病患者的肾脏事件相关。然而，尚未探讨术前获得的它们与临床结局的相关性。TRIBE-AKI队列研究是一项在接受心脏手术的高危成人中进行的前瞻性、多中心、队列研究。我们评估了术前血浆sTNFR 1、sTNFR 2和KIM-1浓度与术后长期结局（包括死亡率、心血管事件和慢性肾脏病（CKD）发生率或出院后进展）之间的相关性。在纳入分析的1378名参与者中，中位随访期为6.7（IQR 4.0-7.9）年，434名（31%）患者死亡，256名（19%）患者发生心血管事件，在837名有长期肾功能数据的患者中，30%发生CKD。校正临床协变量后，生物标志物浓度的每个对数增加与死亡率独立相关，sTNFR 1、sTNFR 2和KIM-1的95%CI校正风险比（aHR）分别为3.0（2.3-4.0）、2.3（1.8-2.9）和2.0（1.6-2.4）。对于心血管事件，sTNFR 1、sTNFR 2和KIM-1的95% CI aHR分别为2.1（1.5-3.1）、1.9（1.4-2.6）和1.6（1.2-2.1）。对于CKD事件，sTNFR 1的aHR为2.2（1.5-3.1），sTNFR 2的aHR为1.9（1.3-2.7），KIM-1的aHR为1.7（1.3-2.3）。尽管存在相关性，但单独或组合的每种生物标志物在绝对基础上或与临床模型相比未能产生稳健的区分。sTNFR 1、sTNFR 2和KIM-1与心脏手术后出院后的纵向结局独立相关，包括高危个体术前获得的死亡、心血管和CKD事件。术前血浆生物标志物可以帮助评估计划进行心脏手术的患者。在线版本包含补充材料，可通过10.1186/s13019-022-02066-4获得。
Soluble tumor necrosis factor receptor (sTNFR)1, sTNFR2, and plasma kidney injury molecule-1 (KIM-1) are associated with kidney events in patients with and without diabetes. However, their associations with clinical outcomes when obtained pre-operatively have not been explored. The TRIBE-AKI cohort study is a prospective, multicenter, cohort study of high-risk adults undergoing cardiac surgery. We assessed the associations between pre-operative concentrations of plasma sTNFR1, sTNFR2, and KIM-1 and post-operative long-term outcomes including mortality, cardiovascular events, and chronic kidney disease (CKD) incidence or progression after discharge. Among 1378 participants included in the analysis with a median follow-up period of 6.7 (IQR 4.0–7.9) years, 434 (31%) patients died, 256 (19%) experienced cardiovascular events and out of 837 with available long-term kidney function data, 30% developed CKD. After adjustment for clinical covariates, each log increase in biomarker concentration was independently associated with mortality with 95% CI adjusted hazard ratios (aHRs) of 3.0 (2.3–4.0), 2.3 (1.8–2.9), and 2.0 (1.6–2.4) for sTNFR1, sTNFR2, and KIM-1, respectively. For cardiovascular events, the 95% CI aHRs were 2.1 (1.5–3.1), 1.9 (1.4–2.6) and 1.6 (1.2–2.1) for sTNFR1, sTNFR2 and KIM-1, respectively. For CKD events, the aHRs were 2.2 (1.5–3.1) for sTNFR1, 1.9 (1.3–2.7) for sTNFR2, and 1.7 (1.3–2.3) for KIM-1. Despite the associations, each of the biomarkers alone or in combination failed to result in robust discrimination on an absolute basis or compared to a clinical model. sTNFR1, sTNFR2, and KIM-1 were independently associated with longitudinal outcomes after discharge from a cardiac surgery hospitalization including death, cardiovascular, and CKD events when obtained pre-operatively in high-risk individuals. Pre-operative plasma biomarkers could serve to assist during the evaluation of patients in whom cardiac surgery is planned. The online version contains supplementary material available at 10.1186/s13019-022-02066-4.
登录
查看更多内容
影响因子：
5.3
作者：
Park M;Maristany D;Huang D;Shlipak MG;Whooley M
通讯作者：
Whooley M
影响因子：
8.2
作者：
Chan L;Nadkarni GN;Fleming F;McCullough JR;Connolly P;Mosoyan G;El Salem F;Kattan MW;Vassalotti JA;Murphy B;Donovan MJ;Coca SG;Damrauer SM
通讯作者：
Damrauer SM
影响因子：
19.6
作者：
Dong, X.;Swaminathan, S.;Griffin, M. D.
通讯作者：
Griffin, M. D.
影响因子：
5.4
作者：
Carlsson, Axel C.;Ruge, Toralph;Arnlov, Johan
通讯作者：
Arnlov, Johan
影响因子：
13.6
作者：
Coca, Steven G.;Garg, Amit X.;Parikh, Chirag R.
通讯作者：
Parikh, Chirag R.