Review
Medicine, General & Internal
Christina Massoth, Alexander Zarbock
Summary: Acute kidney injury after cardiac surgery presents specific patterns of damage and recovery, which are crucial for management and outcomes. The KDIGO classification only partially covers the conceptual framework and is insufficient for a comprehensive diagnosis. This review discusses the strengths and limitations of recent criteria for CSA-AKI and provides an overview of biomarkers. The evolving understanding of CSA-AKI as a time-sensitive condition has led to an increased demand for enhancing diagnostic criteria and implementing biomarkers in clinical practice.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Medicine, General & Internal
Kang Liu, Meiyuan Li, Li Li, Buyun Wu, Xueqiang Xu, Yifei Ge, Huijuan Mao, Changying Xing
Summary: The study found that undergoing cardiac surgery within 7 days after coronary angiography was not associated with increased incidence of postoperative acute kidney injury or worse prognosis. Age, cardiopulmonary bypass, and diabetes were identified as independent risk factors of postoperative acute kidney injury.
FRONTIERS IN MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Christopher T. Ryan, Zijian Zeng, Subhasis Chatterjee, Matthew J. Wall, Marc R. Moon, Joseph S. Coselli, Todd K. Rosengart, Meng Li, Ravi K. Ghanta
Summary: Machine learning models using electronic medical records can predict the risk of acute kidney injury after cardiac surgery, facilitating risk assessment and interventions postoperatively.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Critical Care Medicine
Mira Kuellmar, Khaschayar Saadat-Gilani, Raphael Weiss, Christina Massoth, Anas Lagan, Manuel Nunez Cortes, Joachim Gerss, Lakhmir S. Chawla, Danilo Fliser, Melanie Meersch, Alexander Zarbock
Summary: Elevated renin concentrations are associated with cardiovascular instability and increased AKI after cardiac surgery. Elevated renin concentrations could be used to identify high-risk patients for cardiovascular instability and AKI who would benefit from timely intervention that could improve their outcomes.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Benjamin R. Griffin, J. Pedro Teixeira, Sophia Ambruso, Michael Bronsert, Jay D. Pal, Joseph C. Cleveland, T. Brett Reece, David A. Fullerton, Sarah Faubel, Muhammad Aftab
Summary: This study aimed to investigate the association between stage 1 AKI after surgery and postoperative infection and mortality. The results showed that stage 1 AKI was independently associated with increased infection, ICU LOS, and hospital LOS. Treatment strategies focusing on AKI prevention, early recognition, and optimal medical management may reduce significant postoperative morbidity.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2021)
Article
Transplantation
Gregory L. Hundemer, Anand Srivastava, Kirolos A. Jacob, Neeraja Krishnasamudram, Salman Ahmed, Emily Boerger, Shreyak Sharma, Kapil K. Pokharel, Sameer A. Hirji, Marc Pelletier, Kassem Safa, Win Kulvichit, John A. Kellum, Leonardo Riella, David E. Leaf
Summary: Renal transplant recipients have a higher risk of acute kidney injury following cardiac surgery compared to non-RTRs, especially those with deceased donor status and higher preoperative calcineurin inhibitor trough levels.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2021)
Article
Cardiac & Cardiovascular Systems
Jin Sun Cho, Jae-Kwang Shim, Sak Lee, Jong-Wook Song, Nakcheol Choi, Sugeun Lee, Young-Lan Kwak
Summary: The study revealed that postoperative AKI in valvular heart surgery patients increases the risk of AKD and CKD development, with persistent AKI further escalating this risk. Additionally, heart failure and high right ventricular pressure postoperatively were identified as independent risk factors for CKD.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2021)
Article
Anesthesiology
Lisa Verwijmeren, Madeleen Bosma, Lisette M. Vernooij, Esther M. Linde, Ineke M. Dijkstra, Edgar J. Daeter, Eric P. A. Van Dongen, Wilton A. Van Klei, Peter G. Noordzij
Summary: Preoperative cardiac, inflammatory, renal, and metabolic biomarkers are associated with CSA-AKI and may improve identification of patients at risk. The use of a biomarker panel may enhance the identification of patients with CSA-AKI compared to using only clinical risk factors.
ANESTHESIA AND ANALGESIA
(2021)
Article
Medical Laboratory Technology
Hang Zhang, Hong Lang, Mengqing Ma, Min Yu, Hao Chai, Yuntao Hu, Wen Chen, Xin Chen
Summary: The study found that decreased preoperative uromodulin levels are independently associated with an increased risk of acute kidney injury (AKI) and perioperative kidney dysfunction after cardiac surgery.
CLINICA CHIMICA ACTA
(2022)
Article
Health Care Sciences & Services
Xiao-Qin Luo, Yi-Xin Kang, Shao-Bin Duan, Ping Yan, Guo-Bao Song, Ning-Ya Zhang, Shi-Kun Yang, Jing-Xin Li, Hui Zhang
Summary: This study aimed to develop and validate machine learning models for predicting the occurrence of cardiac surgery-associated acute kidney injury (CSA-AKI) in the pediatric population. The study found that combining preoperative and intraoperative data and using the XGBoost model significantly improved preventive and therapeutic strategies during the perioperative periods. The top five predictors of CSA-AKI were baseline serum creatinine level, perfusion time, body length, operation time, and intraoperative blood loss.
JOURNAL OF MEDICAL INTERNET RESEARCH
(2023)
Article
Anesthesiology
W. Brenton French, Pranav R. Shah, Yahya I. Fatani, Megan M. Rashid, Spencer T. Liebman, Brian J. Cocchiola, Kenneth F. Potter, Salem Rustom, Michael J. Scott
Summary: The study found that postoperative AKI is associated with increased length of hospital stay, higher surgical hospitalization costs, in-hospital mortality, and 1-year mortality, indicating that even patients with mild AKI are at higher risk for complications in both short and long term.
JOURNAL OF CLINICAL ANESTHESIA
(2022)
Article
Medicine, General & Internal
Suk Hyung Choe, Hyeyeon Cho, Jinyoung Bae, Sang-Hwan Ji, Hyun-Kyu Yoon, Ho-Jin Lee, Ji-Hyun Lee, Jin-Tae Kim, Won Ho Kim
Summary: The study aimed to evaluate the association between the duration and stage of acute kidney injury (AKI) and the occurrence of chronic kidney disease (CKD) in patients undergoing cardiac or thoracic aortic surgery. Results showed a significant and graded association between AKI stages and the development of new-onset CKD during three years after surgery, with higher duration and severity of AKI providing stronger predictive value for CKD development.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Matthias Thielmann, David Corteville, Gabor Szabo, Madhav Swaminathan, Andre Lamy, Lukas J. Lehner, Craig D. Brown, Nicolas Noiseux, Mohamed G. Atta, Elizabeth C. Squiers, Shai Erlich, Daniel Rothenstein, Bruce Molitoris, C. David Mazer
Summary: In high-risk patients undergoing cardiac surgery, a single 10 mg/kg dose of teprasiran significantly reduced the incidence, severity, and duration of early AKI compared to placebo.
Article
Medicine, General & Internal
Charat Thongprayoon, Pattharawin Pattharanitima, Andrea G. Kattah, Michael A. Mao, Mira T. Keddis, John J. Dillon, Wisit Kaewput, Supawit Tangpanithandee, Pajaree Krisanapan, Fawad Qureshi, Wisit Cheungpasitporn
Summary: This study aimed to develop and validate an automated machine learning (autoML) prediction model for cardiac surgery-associated acute kidney injury (CSA-AKI). Comparing different models, the autoML model showed the highest predictive performance and had comparable performance to the random forest model, outperforming other models. The autoML model also demonstrated good calibration. This study suggests that the high-performing autoML CSA-AKI prediction model can guide individualized medical plans for cardiac surgery.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Hao Cui, Songren Shu, Yuan Li, Xin Yan, Xiao Chen, Zujun Chen, Yuxuan Hu, Yuan Chang, Zhenliang Hu, Xin Wang, Jiangping Song
Summary: Metabolomics-based biomarkers in plasma samples within 24 hours post cardiac surgery can distinguish patients with acute kidney injury (AKI) from controls. Specific metabolites such as gluconic acid, fumaric acid, and pseudouridine were upregulated in AKI patients. A predictive model utilizing machine learning algorithms and clinical parameters showed excellent discriminative ability for identifying CSA-AKI.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Cardiac & Cardiovascular Systems
Wobo Bekwelem, Stuart J. Connolly, Jonathan L. Halperin, Selcuk Adabag, Sue Duval, Susan Chrolavicius, Janice Pogue, Michael D. Ezekowitz, John W. Eikelboom, Lars G. Wallentin, Salim Yusuf, Alan T. Hirsch
Article
Cardiac & Cardiovascular Systems
Baris Akdemir, Kairav Vakil, David Benditt, Selcuk Adabag
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
(2016)
Article
Cardiac & Cardiovascular Systems
Selcuk Adabag, Rachel R. Huxley, Faye L. Lopez, Lin Y. Chen, Nona Sotoodehnia, David Siscovick, Rajat Deo, Suma Konety, Alvaro Alonso, Aaron R. Folsom
Article
Cardiac & Cardiovascular Systems
Baris Akdemir, Yanhui Li, Balaji Krishnan, Selcuk Adabag, Venkatakrishna Tholakanahalli, David G. Benditt, Jian-Ming Li
Article
Cardiac & Cardiovascular Systems
Selcuk Adabag, Lisa Langsetmo
Article
Cardiac & Cardiovascular Systems
Matthew Hooks, Bradley Bart, Orly Vardeny, Anders Westanmo, Selcuk Adabag
Article
Cardiac & Cardiovascular Systems
Alejandra Gutierrez, Jerry Ash, Baris Akdemir, Tamas Alexy, Rebecca Cogswell, Jane Chen, Selcuk Adabag
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
(2020)
Article
Cardiac & Cardiovascular Systems
Selma Carlson, Amy Gravely, Selcuk Adabag
Summary: Among patients eligible for ICD therapy, there is significant fluctuation in left ventricular ejection fraction (EF), with some patients experiencing improvement followed by subsequent decline. Patients with nonischemic cardiomyopathy were more likely to have EF improvement to >35% at first follow-up compared to those with ischemic cardiomyopathy.
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
(2021)
Editorial Material
Cardiac & Cardiovascular Systems
Selcuk Adabag, Mohammad Madjid, Alan Cheng
EUROPEAN HEART JOURNAL
(2022)
Article
Cardiac & Cardiovascular Systems
Selcuk Adabag, Patrick Zimmerman, Daniel Lexcen, Alan Cheng
Summary: Patients with a post-MI EF >35% have a substantial annual risk of SCA, with factors such as lack of revascularization, post-MI EF <50%, Black race, renal failure, chronic obstructive pulmonary disease, antiarrhythmic therapy, and absence of beta blocker therapy predicting higher risk. Identifying high-risk patients using a multivariable risk model can help in further risk assessment and monitoring to prevent SCA.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Cardiac & Cardiovascular Systems
Selcuk Adabag, Patrick Zimmerman, Adam Black, Mohammad Madjid, Payam Safavi-Naeini, Alan Cheng
Summary: An increase in defibrillator shock episodes was observed in New York City, New Orleans, and Boston during the surge of COVID-19 activity, especially among patients who had experienced one or more shocks previously. However, the likelihood of any given patient having a shock episode did not differ between 2020 and 2019.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Cardiac & Cardiovascular Systems
Selcuk Adabag, Selma Carlson, Amy Gravely, Melissa Buelt-Gebhardt, Mohammad Madjid, Niyada Naksuk
Summary: One-third of ICD-eligible patients undergoing CABG show significant improvement in EF, reducing the need for primary prevention ICD implantation. EF improvement is associated with lower risks of all-cause mortality and heart failure mortality.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
Selcuk Adabag, Scott Hubers
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Arianne Clare Agdamag, Anders Westanmo, Amy Gravely, Natthapon Angsubhakorn, Lin Yee Chen, Selcuk Adabag
Summary: This study retrospectively analyzed the medical records of 8204 atrial fibrillation patients who were prescribed antiarrhythmic medications. It found that among patients with left ventricular hypertrophy, amiodarone use was associated with a higher risk of mortality compared to other antiarrhythmic medications.
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
(2023)
Letter
Cardiac & Cardiovascular Systems
Michael C. Downey, Matthew Hooks, Selcuk Adabag