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Association of cardiac biomarkers with acute kidney injury after cardiac surgery: A multicenter cohort study.

Publication ,  Journal Article
Belley-Côté, EP; Parikh, CR; Shortt, CR; Coca, SG; Garg, AX; Eikelboom, JW; Kavsak, P; McArthur, E; Thiessen-Philbrook, H; Whitlock, RP ...
Published in: J Thorac Cardiovasc Surg
July 2016

OBJECTIVE: Acute kidney injury is common after cardiac surgery and associated with postoperative mortality. Perioperative cardiac biomarkers may predict acute kidney injury and mortality. We evaluated whether cardiac biomarkers were associated with severe acute kidney injury, defined as a doubling in serum creatinine or requiring renal replacement therapy during hospital stay after surgery, and mortality. METHODS: In a prospective multicenter cohort of adults undergoing cardiac surgery, we measured the following biomarkers in preoperative and postoperative banked plasma: high-sensitivity troponin T, cardiac troponin I, creatine kinase-MB, and N-terminal prohormone of brain natriuretic peptide. RESULTS: In the patients who were discharged alive, severe acute kidney injury occurred in 37 of 960 (3.9%), and 43 of 960 (4.5%) died within 1 year of follow-up. N-terminal prohormone of brain natriuretic peptide was the only preoperative biomarker that was independently associated with severe acute kidney injury (with log transformation, adjusted odds ratio, 1.4; 95% confidence interval, 1.0-1.9). Biomarkers measured within 6 hours of surgery (day 1) were all associated with severe acute kidney injury. Preoperative N-terminal prohormone of brain natriuretic peptide was also independently associated with 1-year mortality (with log transformation, adjusted odds ratio, 1.7; 95% confidence interval, 1.2-2.2). Patients in the highest tertile for N-terminal prohormone of brain natriuretic peptide preoperatively (>1006.4 ng/L) had marked increases in their risk for 1-year mortality (adjusted odds ratio, 27.2; 95% confidence interval, 3.5-213.5). Day 1 N-terminal prohormone of brain natriuretic peptide was associated with mortality independently of change in serum creatinine from preoperative baseline. CONCLUSIONS: Of the studied biomarkers, N-terminal prohormone of brain natriuretic peptide was the only preoperative biomarker independently associated with severe acute kidney injury and mortality. Early increases in postoperative cardiac biomarkers were associated with severe acute kidney injury after cardiac surgery. Future research should focus on whether interventions that lower N-terminal prohormone of brain natriuretic peptide can affect postoperative outcomes.

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Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

July 2016

Volume

152

Issue

1

Start / End Page

245 / 251.e4

Location

United States

Related Subject Headings

  • United States
  • Troponin T
  • Troponin I
  • Respiratory System
  • Prospective Studies
  • Postoperative Complications
  • Peptide Fragments
  • Ontario
  • Natriuretic Peptide, Brain
  • Male
 

Citation

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Belley-Côté, E. P., Parikh, C. R., Shortt, C. R., Coca, S. G., Garg, A. X., Eikelboom, J. W., … TRIBE-AKI Consortium, . (2016). Association of cardiac biomarkers with acute kidney injury after cardiac surgery: A multicenter cohort study. J Thorac Cardiovasc Surg, 152(1), 245-251.e4. https://doi.org/10.1016/j.jtcvs.2016.02.029
Belley-Côté, Emilie P., Chirag R. Parikh, Colleen R. Shortt, Steven G. Coca, Amit X. Garg, John W. Eikelboom, Peter Kavsak, et al. “Association of cardiac biomarkers with acute kidney injury after cardiac surgery: A multicenter cohort study.J Thorac Cardiovasc Surg 152, no. 1 (July 2016): 245-251.e4. https://doi.org/10.1016/j.jtcvs.2016.02.029.
Belley-Côté EP, Parikh CR, Shortt CR, Coca SG, Garg AX, Eikelboom JW, et al. Association of cardiac biomarkers with acute kidney injury after cardiac surgery: A multicenter cohort study. J Thorac Cardiovasc Surg. 2016 Jul;152(1):245-251.e4.
Belley-Côté, Emilie P., et al. “Association of cardiac biomarkers with acute kidney injury after cardiac surgery: A multicenter cohort study.J Thorac Cardiovasc Surg, vol. 152, no. 1, July 2016, pp. 245-251.e4. Pubmed, doi:10.1016/j.jtcvs.2016.02.029.
Belley-Côté EP, Parikh CR, Shortt CR, Coca SG, Garg AX, Eikelboom JW, Kavsak P, McArthur E, Thiessen-Philbrook H, Whitlock RP, TRIBE-AKI Consortium. Association of cardiac biomarkers with acute kidney injury after cardiac surgery: A multicenter cohort study. J Thorac Cardiovasc Surg. 2016 Jul;152(1):245-251.e4.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

July 2016

Volume

152

Issue

1

Start / End Page

245 / 251.e4

Location

United States

Related Subject Headings

  • United States
  • Troponin T
  • Troponin I
  • Respiratory System
  • Prospective Studies
  • Postoperative Complications
  • Peptide Fragments
  • Ontario
  • Natriuretic Peptide, Brain
  • Male