Ke Chen, Dongxu Wang, Minhua Fang, Pengyu Wang, Peng Hou, Yu Liu, Liming Yu, Zijun Zhou, Juan Gao, Yong Zhang
{"title":"血清 CIRP 对全主动脉弓置换术后急性肾损伤的预测价值","authors":"Ke Chen, Dongxu Wang, Minhua Fang, Pengyu Wang, Peng Hou, Yu Liu, Liming Yu, Zijun Zhou, Juan Gao, Yong Zhang","doi":"10.1155/2024/4814978","DOIUrl":null,"url":null,"abstract":"<div>\n <p><i>Objectives</i>. To investigate the predictive value of serum cold-inducible RNA-binding protein (CIRP) and postoperative acute kidney injury (AKI) after total aortic arch replacement. <i>Methods</i>. Eighty-six patients with acute Stanford type A aortic dissection (ATAAD) admitted to hospital from October 2019 to February 2021 were retrospectively selected as the study subjects. All patients underwent total aortic arch replacement under moderate hypothermic circulatory arrest (MHCA) with selective antegrade cerebral perfusion (SACP). Detection of the level of serum CIRP after admission and perioperative clinical data of patients were collected and analyzed. Kidney Disease: Improving Global Outcomes (KDIGO) criteria were used to stage renal function. Patients were divided into a non-AKI-3 group (<i>n</i> = 70) and an AKI-3 group (<i>n</i> = 16) according to the stage of postoperative renal function. The risk factors for postoperative AKI KDIGO stage 3 were analyzed by a multivariate logistic regression model. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy. <i>Results</i>. In 86 patients, postoperative AKI-3 stage accounted for 18.6% (16/86). Compared with the non-AKI-3 group, the AKI-3 group had a higher preoperative BMI index, C-reactive protein, and CIRP level; a longer intraoperative cooling time, cardiopulmonary bypass time, and aortic cross-clamping time; and a higher intraoperative coronary artery bypass ratio (all <i>P</i> < 0.05). Multivariate logistic regression results showed that CIRP (OR = 1.001, 95% CI: 1.000–1.002, <i>P</i> = 0.012) was an independent risk factor for postoperative AKI KDIGO stage 3. <i>Conclusion</i>. The serum CIRP is associated with postoperative acute kidney injury after total aortic arch replacement in ATAAD patients and may serve as a predictive indicator for early detection and intervention to improve the prognosis.</p>\n </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/4814978","citationCount":"0","resultStr":"{\"title\":\"Predictive Value of Serum CIRP in Acute Kidney Injury after Total Aortic Arch Replacement\",\"authors\":\"Ke Chen, Dongxu Wang, Minhua Fang, Pengyu Wang, Peng Hou, Yu Liu, Liming Yu, Zijun Zhou, Juan Gao, Yong Zhang\",\"doi\":\"10.1155/2024/4814978\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><i>Objectives</i>. To investigate the predictive value of serum cold-inducible RNA-binding protein (CIRP) and postoperative acute kidney injury (AKI) after total aortic arch replacement. <i>Methods</i>. Eighty-six patients with acute Stanford type A aortic dissection (ATAAD) admitted to hospital from October 2019 to February 2021 were retrospectively selected as the study subjects. All patients underwent total aortic arch replacement under moderate hypothermic circulatory arrest (MHCA) with selective antegrade cerebral perfusion (SACP). Detection of the level of serum CIRP after admission and perioperative clinical data of patients were collected and analyzed. Kidney Disease: Improving Global Outcomes (KDIGO) criteria were used to stage renal function. Patients were divided into a non-AKI-3 group (<i>n</i> = 70) and an AKI-3 group (<i>n</i> = 16) according to the stage of postoperative renal function. The risk factors for postoperative AKI KDIGO stage 3 were analyzed by a multivariate logistic regression model. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy. <i>Results</i>. In 86 patients, postoperative AKI-3 stage accounted for 18.6% (16/86). Compared with the non-AKI-3 group, the AKI-3 group had a higher preoperative BMI index, C-reactive protein, and CIRP level; a longer intraoperative cooling time, cardiopulmonary bypass time, and aortic cross-clamping time; and a higher intraoperative coronary artery bypass ratio (all <i>P</i> < 0.05). Multivariate logistic regression results showed that CIRP (OR = 1.001, 95% CI: 1.000–1.002, <i>P</i> = 0.012) was an independent risk factor for postoperative AKI KDIGO stage 3. <i>Conclusion</i>. The serum CIRP is associated with postoperative acute kidney injury after total aortic arch replacement in ATAAD patients and may serve as a predictive indicator for early detection and intervention to improve the prognosis.</p>\\n </div>\",\"PeriodicalId\":15367,\"journal\":{\"name\":\"Journal of Cardiac Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/4814978\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cardiac Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/2024/4814978\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiac Surgery","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/2024/4814978","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Predictive Value of Serum CIRP in Acute Kidney Injury after Total Aortic Arch Replacement
Objectives. To investigate the predictive value of serum cold-inducible RNA-binding protein (CIRP) and postoperative acute kidney injury (AKI) after total aortic arch replacement. Methods. Eighty-six patients with acute Stanford type A aortic dissection (ATAAD) admitted to hospital from October 2019 to February 2021 were retrospectively selected as the study subjects. All patients underwent total aortic arch replacement under moderate hypothermic circulatory arrest (MHCA) with selective antegrade cerebral perfusion (SACP). Detection of the level of serum CIRP after admission and perioperative clinical data of patients were collected and analyzed. Kidney Disease: Improving Global Outcomes (KDIGO) criteria were used to stage renal function. Patients were divided into a non-AKI-3 group (n = 70) and an AKI-3 group (n = 16) according to the stage of postoperative renal function. The risk factors for postoperative AKI KDIGO stage 3 were analyzed by a multivariate logistic regression model. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy. Results. In 86 patients, postoperative AKI-3 stage accounted for 18.6% (16/86). Compared with the non-AKI-3 group, the AKI-3 group had a higher preoperative BMI index, C-reactive protein, and CIRP level; a longer intraoperative cooling time, cardiopulmonary bypass time, and aortic cross-clamping time; and a higher intraoperative coronary artery bypass ratio (all P < 0.05). Multivariate logistic regression results showed that CIRP (OR = 1.001, 95% CI: 1.000–1.002, P = 0.012) was an independent risk factor for postoperative AKI KDIGO stage 3. Conclusion. The serum CIRP is associated with postoperative acute kidney injury after total aortic arch replacement in ATAAD patients and may serve as a predictive indicator for early detection and intervention to improve the prognosis.
期刊介绍:
Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide.
With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery.
In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.