Background: Severe acute kidney injury (AKI) after cardiac surgery is associated with poor clinical outcomes. This study evaluated the potential use of miR-21 as a risk marker for postoperative AKI progression and other poor outcomes.
Methodology/principal Findings: The study included 120 adult patients undergoing cardiac surgery: 40 non-AKI controls, 39 patients with progressive AKI, and 41 with non-progressive AKI. Urine and plasma levels of miR-21 were assessed by quantitative real-time PCR (RT-qPCR). Associations between miR-21 levels and AKI progression were determined by estimating areas under receiver operating characteristic curves (AUC). We demonstrated that up-regulated urine and plasma levels of miR-21 in patients with AKI were both associated with AKI progression. The AUCs for urine and plasma levels of miR-21 associated with established AKI were 0.68 (95%CI: 0.59-0.78) and 0.80 (95%CI: 0.73-0.88), respectively. Multiple logistic regression analysis, adjusting for clinical variables, indicated that the prognostic predictive power of urine and plasma miR-21 levels for AKI progression were represented by AUCs of 0.81 (95%CI: 0.72-0.91) and 0.83 (95%CI: 0.74-0.92), respectively. Urinary and plasma miR-21 levels also predicted the need for postoperative renal replacement therapy (RRT), development of Acute Kidney Injury Network (AKIN) stage 3 AKI, 30-day in-hospital mortality and prolonged stay in hospital or ICU. Urine miR-21 was a better outcome predictor than plasma miR-21, being associated with higher (1.4- to 2.6-fold) unadjusted odds ratio for progression of AKI and other poor outcomes.
Conclusions: Urinary and plasma miR-21 are associated with severe AKI and other poor postoperative outcomes of cardiac surgery, indicating their potential use as prognostic markers.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662667 | PMC |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0063390 | PLOS |
Simul Healthc
December 2024
From the Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium (L.D.M., I.V.H., L.D., W.W.); Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium (I.V.H., L.D.); Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium (P.V.d.V.); Department of Emergency Medicine, Ghent University Hospital, Ghent, Belgium (P.V.d.V.); Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium (H.V., W.W.); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (L.K.); and Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen, Denmark (L.K.).
Introduction: Chest tube insertions (CTIs) have a high complication rate, prompting the training of technical skills in simulated settings. However, assessment tools require validity evidence prior to their implementation. This study aimed to collect validity evidence for assessment of technical skills in CTI on Thiel-embalmed human bodies.
View Article and Find Full Text PDFJ Pediatr Orthop
December 2024
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
Background: Vertebral body tethering (VBT) is a nonfusion surgical treatment for scoliosis. Recent data have shown that intraoperative correction is critical for successful curve correction over time. This study aims to evaluate the relationship between preoperative, intraoperative, and postoperative correction.
View Article and Find Full Text PDFChin Med J (Engl)
December 2024
Cardiac Surgery, Cardiac Center, The First Hospital of Tsinghua University, Chaoyang District, Beijing 100016, China.
Coron Artery Dis
October 2024
Department of Cardiology, Istanbul University - Cerrahpasa Institute of Cardiology.
Introduction: The Naples prognostic score (NPS) is a novel indicator of nutritional and inflammatory statuses in cancer patients. Development of atrial fibrillation after cardiac surgery (POAF) is a common complication that increases the incidence of adverse events. Numerous studies have investigated predictors of POAF.
View Article and Find Full Text PDFASAIO J
December 2024
Cleveland Clinic Florida, Heart, Vascular and Thoracic Institute, Advanced Heart Failure Program, Weston, Florida.
We investigated the association of preimplant left ventricular end-diastolic diameter (LVEDD) with outcomes after HeartMate 3 (HM3) left ventricular assist device (LVAD) implantation. Patients from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) registry who underwent HM3 implantation from August 2014 to February 2023 (n = 834) were analyzed according to preoperative LVEDD: less than or equal to 65 (n = 251), 65-80 (n = 441), and greater than or equal to 80 mm (n = 142). The mean age was 54.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!