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Sanders J, Makariou N, Tocock A, Magboo R, Thomas A, Aitken LM. OUP accepted manuscript. Eur J Cardiovasc Nurs 2022; 21:655-664. [PMID: 35171231 DOI: 10.1093/eurjcn/zvac003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/20/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Julie Sanders
- St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7DN, UK
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - Nicole Makariou
- Barts and the London Medical School, Queen Mary University of London, Charterhouse Square, London, UK
| | - Adam Tocock
- Knowledge and Library Services, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, UK
| | - Rosalie Magboo
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, UK
- Critical Care, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, UK
| | - Ashley Thomas
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, UK
- Critical Care, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, UK
| | - Leanne M Aitken
- School of Health Sciences, City, University of London, Northampton Square, London, UK
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The predictive value of TIMP-2 and IGFBP7 for kidney failure and 30-day mortality after elective cardiac surgery. Sci Rep 2021; 11:1071. [PMID: 33441876 PMCID: PMC7806984 DOI: 10.1038/s41598-020-80196-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 11/25/2020] [Indexed: 12/29/2022] Open
Abstract
Acute kidney injury (AKI) is an important risk factor for chronic kidney disease, renal replacement therapy (RRT), and mortality. However, predicting AKI with currently available markers remains problematic. We assessed the predictive value of urinary tissue inhibitor of metalloprotease-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) regarding the need for RRT, and 30-day mortality, in elective cardiac surgery patients. In 344 elective cardiac surgery patients, we measured urinary TIMP-2 and IGFBP7 and serum creatinine at baseline and directly after surgery. Discrimination of both urinary biomarkers was assessed by the C-statistic. Model improvement for each biomarker when added to a basic model containing serum creatinine and duration of surgery was tested by the net-reclassification index (cf-NRI) and integrated discrimination index (IDI). At baseline, mean age was 66 years and 67% were men. Of all patients, 22 required RRT following surgery. IGFBP7 pre- and post-surgery and change in TIMP-2 during surgery predicted RRT with a C-statistic of about 0.80. However, a simple model including baseline serum creatinine and duration of surgery had a C-statistic of 0.92, which was improved to 0.93 upon addition of post-surgery TIMP-2 or IGFBP7, with statistically significant cf-NRIs but non-significant IDIs. Post-surgery TIMP-2 and IGFBP predicted 30-day mortality, with C-statistics of 0.74 and 0.80. In conclusion, in elective cardiac surgery patients, pre- and peri-operative clinical variables were highly discriminating about which patients required RRT after surgery. Nonetheless, in elective cardiac surgery patients, urinary TIMP-2 and IGFBP7 improved prediction of RRT and 30-day mortality post-surgery.
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van Paassen J, van Dissel JT, Hiemstra PS, Zwaginga JJ, Cobbaert CM, Juffermans NP, de Wilde RB, Stijnen T, de Jonge E, Klautz RJ, Arbous MS. Perioperative proADM-change is associated with the development of acute respiratory distress syndrome in critically ill cardiac surgery patients: a prospective cohort study. Biomark Med 2019; 13:1081-1091. [PMID: 31544475 DOI: 10.2217/bmm-2019-0028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Biomarkers of acute respiratory distress syndrome (ARDS) after cardiac-surgery may help risk-stratification and management. Preoperative single-value proADM increases predictive capacity of scoring-system EuroSCORE. To include the impact of surgery, we aim to assess the predictive value of the perioperative proADM-change on development of ARDS in 40 cardiac-surgery patients. Materials & methods: ProADM was measured in nine sequential blood samples. The Berlin definition of ARDS was used. For data-analyses, a multivariate model of EuroSCORE and perioperative proADM-change, linear mixed models and logistic regression were used. Results: Perioperative proADM-change was associated with ARDS after cardiac-surgery, and it was superior to EuroSCORE. A perioperative proADM-change >1.5 nmol/l could predict ARDS. Conclusion: Predicting post-surgery ARDS with perioperative proADM-change enables clinicians to intensify lung-protective interventions and individualized fluid therapy to minimize secondary injury.
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Affiliation(s)
- Judith van Paassen
- Department of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaap T van Dissel
- Department of Infectious Disease, Leiden University Medical Center, Leiden, The Netherlands.,Center for Infectious Disease Control, National Institute of Public Health & the Environment, Bilthoven, The Netherlands
| | - Pieter S Hiemstra
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaap Jan Zwaginga
- Department of Immunohematology & Blood transfusion, Leiden University Medical Center, Leiden, The Netherlands.,Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | - Christa M Cobbaert
- Department of Clinical Chemistry & Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicole P Juffermans
- Department of Intensive Care & Laboratory of Experimental Intensive Care & Anesthesiology (L.E.I.C.A.), Amsterdam Medical Centre, Amsterdam, The Netherlands
| | - Rob B de Wilde
- Department of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Theo Stijnen
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Evert de Jonge
- Department of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert J Klautz
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - M Sesmu Arbous
- Department of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Schoe A, de Jonge E, Klautz RJM, van Dissel JT, van de Vosse E. Single-Nucleotide Polymorphisms in the CALCA Gene Are Associated with Variation of Procalcitonin Concentration in Patients Undergoing Cardiac Surgery. Am J Respir Crit Care Med 2017; 194:767-9. [PMID: 27628079 DOI: 10.1164/rccm.201604-0772le] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Abraham Schoe
- 1 Leiden University Medical Center Leiden, the Netherlands
| | - Evert de Jonge
- 1 Leiden University Medical Center Leiden, the Netherlands
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