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Ann Thorac Surg. 2017 Aug;104(2):613-620. doi: 10.1016/j.athoracsur.2016.11.036. Epub 2017 Feb 21.

Plasma Monocyte Chemotactic Protein-1 Is Associated With Acute Kidney Injury and Death After Cardiac Operations.

Author information

1
Program of Applied Translational Research, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
2
Institute for Clinical Evaluative Sciences Western, London, Ontario, Canada.
3
Division of Nephrology, Department of Medicine, and Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada.
4
Kidney Health Research Collaborative, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, California.
5
Division of Cardiac Surgery, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
6
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
7
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
8
Program of Applied Translational Research, Department of Medicine, Yale School of Medicine, New Haven, Connecticut; Department of Internal Medicine, Veterans Affairs Medical Center, West Haven, Connecticut. Electronic address: chirag.parikh@yale.edu.

Abstract

BACKGROUND:

Monocyte chemotactic protein-1 (MCP-1; chemokine C-C ligand-2 [CCL-2]) is upregulated in ischemia-reperfusion injury and is a promising biomarker of inflammation in cardiac operations.

METHODS:

We measured preoperative and postoperative plasma MCP-1 levels in adults undergoing cardiac operations to evaluate the association of perioperative MCP-1 levels with acute kidney injury (AKI) and death in Translational Research Investigating Biomarker Endpoints in AKI (TRIBE-AKI), a prospective, multicenter, observational cohort.

RESULTS:

Of the 972 participants in the study, AKI developed in 329 (34%), and severe AKI developed in 45 (5%). During a median follow-up of 2.9 years (interquartile range, 2.2 to 3.5 years), 119 participants (12%) died. MCP-1 levels were significantly higher in those who developed AKI and died than in those without AKI and death. Participants with a preoperative MCP-1 level in the highest tertile (>196 pg/mL) had an increased AKI risk than those in the lowest tertile (<147 pg/mL; odds ratio [OR], 1.43l; 95% confidence interval [CI], 1.00 to 2.05). The association appeared similar but was not significant for the severe AKI outcome (OR, 1.48; 95% CI, 0.62 to 3.54). Compared with participants with preoperative MCP-1 level in the lowest tertile, those in the highest tertile had higher adjusted risk of death (hazard ratio, 1.82; 95% CI, 1.40 to 2.38). Similarly, participants in the highest tertile had a higher adjusted risk of death (hazard ratio, 1.95; 95% CI, 1.09-3.49) than those with a postoperative MCP-1 level in the lowest tertile.

CONCLUSIONS:

Higher plasma MCP-1 is associated with increased AKI and risk of death after cardiac operations. MCP-1 could be used as a biomarker to identify high-risk patients for potential AKI prevention strategies in the setting of cardiac operations.

Comment in

PMID:
28223055
PMCID:
PMC5588689
[Available on 2018-08-01]
DOI:
10.1016/j.athoracsur.2016.11.036
[Indexed for MEDLINE]
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