title: Plasma Monocyte Chemotactic Protein-1 Is Associated With Acute Kidney Injury and Death After Cardiac Operations.
abstract: BACKGROUND
  Monocyte chemotactic protein-1 (MCP-1; chemokine C-C ligand-2 [CCL-2]) is upregulated in ischemia-reperfusion injury and is a promising biomarker of inflammation in cardiac operations.
  
  
  METHODS
  We measured preoperative and postoperative plasma MCP-1 levels in adults undergoing cardiac operations to evaluate the association of perioperative MCP-1 levels with acute kidney injury (AKI) and death in Translational Research Investigating Biomarker Endpoints in AKI (TRIBE-AKI), a prospective, multicenter, observational cohort.
  
  
  RESULTS
  Of the 972 participants in the study, AKI developed in 329 (34%), and severe AKI developed in 45 (5%). During a median follow-up of 2.9 years (interquartile range, 2.2 to 3.5 years), 119 participants (12%) died. MCP-1 levels were significantly higher in those who developed AKI and died than in those without AKI and death. Participants with a preoperative MCP-1 level in the highest tertile (>196 pg/mL) had an increased AKI risk than those in the lowest tertile (<147 pg/mL; odds ratio [OR], 1.43l; 95% confidence interval [CI], 1.00 to 2.05). The association appeared similar but was not significant for the severe AKI outcome (OR, 1.48; 95% CI, 0.62 to 3.54). Compared with participants with preoperative MCP-1 level in the lowest tertile, those in the highest tertile had higher adjusted risk of death (hazard ratio, 1.82; 95% CI, 1.40 to 2.38). Similarly, participants in the highest tertile had a higher adjusted risk of death (hazard ratio, 1.95; 95% CI, 1.09-3.49) than those with a postoperative MCP-1 level in the lowest tertile.
  
  
  CONCLUSIONS
  Higher plasma MCP-1 is associated with increased AKI and risk of death after cardiac operations. MCP-1 could be used as a biomarker to identify high-risk patients for potential AKI prevention strategies in the setting of cardiac operations.
authors.affiliation: Program of Applied Translational Research, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Dennis G
authors.initials: DG
authors.lastname: Moledina
authors.affiliation: Program of Applied Translational Research, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Selin
authors.initials: S
authors.lastname: Isguven
authors.affiliation: Institute for Clinical Evaluative Sciences Western, London, Ontario, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: McArthur
authors.affiliation: Program of Applied Translational Research, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Heather
authors.initials: H
authors.lastname: Thiessen-Philbrook
authors.affiliation: Division of Nephrology, Department of Medicine, and Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada.
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
authors.affiliation: Kidney Health Research Collaborative, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, California.
authors.forename: Michael
authors.initials: M
authors.lastname: Shlipak
authors.affiliation: Division of Cardiac Surgery, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Whitlock
authors.affiliation: Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Kavsak
authors.affiliation: Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Coca
authors.affiliation: Program of Applied Translational Research, Department of Medicine, Yale School of Medicine, New Haven, Connecticut; Department of Internal Medicine, Veterans Affairs Medical Center, West Haven, Connecticut. Electronic address: chirag.parikh@yale.edu.
authors.forename: Chirag R
authors.initials: CR
authors.lastname: Parikh
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D000368:Aged; D015415:Biomarkers / Q000097:blood; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002423:Cause of Death / Q000639:trends; D018932:Chemokine CCL2 / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000097:blood / Q000401:mortality / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology*; D057234:Preoperative Period; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2