Evidence map›Paper›PMID 27609347›Full record

Observational studyBMC anesthesiology2016

Early prediction of acute kidney injury after transapical and transaortic aortic valve implantation with urinary G1 cell cycle arrest biomarkers.

Fabian Dusse, Michaela Edayadiyil-Dudásova, Matthias Thielmann, Daniel Wendt, Philipp Kahlert, Ender Demircioglu, Heinz Jakob, Simon T Schaefer, Kevin Pilarczyk

Erratum issuedOpen access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC anesthesiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 32 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 8 pooled it
4.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 8 syntheses or guidelines pooled it, 72 citations in OpenAlex.

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  3. Biomarkers of acute kidney injury in pediatric cardiac surgery.Pediatric nephrology (Berlin, Germany) · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Fabian DusseDepartment of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany. Fabian.dusse@uk-essen.de.
Michaela Edayadiyil-DudásovaDepartment of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany.
Matthias ThielmannDepartment of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany.
Daniel WendtDepartment of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany.
Philipp KahlertDepartment of Cardiology, West German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany.
Ender DemirciogluDepartment of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany.
Heinz JakobDepartment of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany.
Simon T SchaeferKlinik für Anästhesiologie und Intensivmedizin, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany.
Kevin PilarczykDepartment of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany.
Essen University Hospital · DEWest German Heart and Vascular Center Essen · DEInstitut für Berufliche Aus- und Fortbildung · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute kidney injury (AKI) is a common complication following transcatheter aortic valve implantation (TAVI) leading to increased mortality and morbidity. Urinary G1 cell cycle arrest proteins TIMP-2 and IGFBP7 have recently been suggested as sensitive biomarkers for early detection of AKI in critically ill patients. However, the precise role of urinary TIMP-2 and IGFBP7 in patients undergoing TAVI is unknown.

methodsIn a prospective observational trial, 40 patients undergoing TAVI (either transaortic or transapical) were enrolled. Serial measurements of TIMP-2 and IGFBP7 were performed in the early post interventional course. The primary clinical endpoint was the occurrence of AKI stage 2/3 according to the KDIGO classification.

resultsNow we show, that ROC analyses of [TIMP-2]*[IGFBP7] on day one after TAVI reveals a sensitivity of 100 % and a specificity of 90 % for predicting AKI 2/3 (AUC 0.971, 95 % CI 0.914-1.0, SE 0.0299, p = 0.001, cut-off 1.03). In contrast, preoperative and postoperative serum creatinine levels as well as glomerular filtration rate (GFR) and perioperative change in GFR did not show any association with the development of AKI. Furthermore, [TIMP-2]*[IGFBP7] remained stable in patients with AKI ≤1, but its levels increased significantly as early as 24 h after TAVI in patients who developed AKI 2/3 in the further course (4.77 ± 3.21 vs. 0.48 ± 0.68, p = 0.022). Mean patients age was 81.2 ± 5.6 years, 16 patients were male (40.0 %). 35 patients underwent transapical and five patients transaortic TAVI. 15 patients (37.5 %) developed any kind of AKI; eight patients (20 %) met the primary endpoint and seven patients required renal replacement therapy (RRT) within 72 h after surgery.

conclusionEarly elevation of urinary cell cycle arrest biomarkers after TAVI is associated with the development of postoperative AKI. [TIMP-2]*[IGFBP7] provides an excellent diagnostic accuracy in the prediction of AKI that is superior to that of serum creatinine.

Indexed as

G1 Phase Cell Cycle CheckpointsPredictive Value of TestsAcute Kidney InjuryAged, 80 and overBiomarkersCreatinineFemaleGlomerular Filtration RateHeart Valve Prosthesis ImplantationHumansInsulin-Like Growth Factor Binding ProteinsMaleSensitivity and SpecificityTissue Inhibitor of Metalloproteinase-2BiomarkersCreatinineinsulin-like growth factor binding protein-related protein 1Insulin-Like Growth Factor Binding ProteinsTIMP2 protein, humanTissue Inhibitor of Metalloproteinase-2Acute kidney injuryAKIBiomarkerCell cycle arrestIGFBP7NephroCheckTAVITAVRTIMP-2

Identifiers

PMID27609347
PMCPMC5016985
OpenAlexW2515699319

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.