The following is a summary of “Kidney Cell Cycle Arrest and Cardiac Biomarkers and Acute Kidney Injury Following Angiography: The Prevention of Serious Adverse Events Following Angiography (PRESERVE) Study,” published in the March 2023 issue of Kidney Medicine by Murugan et al.
Most occurrences of contrast-associated acute kidney injury (CA-AKI) are minor and unrelated to the rise in kidney injury biomarkers, according to recent research in individuals with chronic kidney disease (CKD). Therefore, researchers used extremely sensitive kidney cell cycle arrest and cardiac biomarkers to evaluate the risk of CA-AKI and significant adverse renal events in CKD patients undergoing angiography. A sample of 922 people took part in the trial to reduce the risk of serious complications after angiography. Samples were taken 1-2 hours before and 2-4 hours after angiography to measure plasma natriuretic peptide (BNP), high-sensitivity C-reactive protein (hs-CRP), and serum troponin (Tn) in 742 subjects, and urinary tissue inhibitor of matrix metalloproteinase [TIMP]-2 and insulin growth factor binding protein [IGFBP]-7 in 854 participants.
Patients with and without CA-AKI and significant adverse renal events had similar amounts of urinary [TIMP-2]•[IGFBP7], plasma BNP, serum Tn, and hs-CRP following angiography. However, higher pre- and post angiography median plasma BNP (pre: 200.0 vs. 71.5, pg/mL, P = 0.05; post: 165.0 vs. 81 pg/mL, P = 0.02); serum Tn (pre: 0.03 vs. 0.01, ng/mL, P < 0.001; post, 0.04 vs. 0.02, ng/mL, P = 0.01); and hs-CRP (pre: 9.55 vs. 3.40 mg/L, P = 0.01; post: 9.90 vs. 3.20 mg/L, P = 0.002) concentrations were associated with significant adverse kidney events, although their discriminatory capacity was only modest (area under the receiver operating characteristic curves <0.7). Most occurrences of moderate CA-AKI are not linked to an increase in the biomarker in the urine that indicates cell cycle arrest. Independent of CA-AKI status, patients with significantly elevated pre angiography cardiac biomarkers may suggest more severe cardiovascular disease.
Source: sciencedirect.com/science/article/pii/S2590059522002254
