Abstract: FR-PO117

Relationship of Cardiac Biomarkers and AKI: The ASSESS-AKI Study

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Liu, Kathleen D., University of California San Francisco, San Francisco, California, United States
  • Chinchilli, Vernon M., Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Kimmel, Paul L., National Institute of Diabetes and Digestive Kidney Diseases (NIDDK), Bethesda, Maryland, United States
  • Kaufman, James S., VA New York Harbor Healthcare System, New York, New York, United States
  • Go, Alan S., Kaiser Permanente Northern California, Oakland, California, United States
  • Hsu, Chi-yuan, University of California San Francisco, San Francisco, California, United States
  • Tan, Thida C., Kaiser Permanente Northern California, Oakland, California, United States
  • Arends, Valerie, University of Minnesota, Minneapolis, Minnesota, United States
  • Saenger, Amy, University of Minnesota, Minneapolis, Minnesota, United States
  • Parikh, Chirag R., Yale University and VAMC, New Haven, Connecticut, United States
  • Ikizler, Talat Alp, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Himmelfarb, Jonathan, Kidney Research Institute, Seattle, Washington, United States
  • Wurfel, Mark M., University of Washington, Seattle, Washington, United States

Group or Team Name

  • For ASSESS-AKI Study Investigators
Background

Several studies have reported AKI is associated with an increased risk of cardiovascular events after hospital discharge, especially heart failure. However, little is known about whether AKI impacts heart failure biomarker levels.

Methods

ASSESS-AKI study is a parallel cohort study of hospitalized AKI and matched non-AKI patients enrolled in 2009-2015. Plasma biospecimens were collected during the index hospitalization (V0) and at the first outpatient study visit 3 months later (V3) and tested for levels of Suppression of tumorigenicity 2 (ST-2) and galectin-3 (GAL-3) using clinical grade ELISA assays (Critical Diagnostics and BG Medicine, respectively).

Results

Mean age of the 1,484 participants analyzed was 55 yr, 48% were women, and baseline (pre-index admission) eGFR was 69 mL/min/1.73m2. Compared to non-AKI patients, ST-2 and GAL-3 levels were higher in AKI patients during the index hospitalization and at V3 (Table), and both duration and severity of AKI were associated with biomarker levels (p< 0.001 for all comparisons). Of note, ST-2 levels fell markedly from V0 to V3 in both groups, to median ST-2 levels that are typically associated with a lower risk of heart failure (< 35 ng/mL).

Conclusion

ST-2 and GAL-3 are elevated during an episode of AKI, with GAL-3 remaining elevated but ST-2 declining at 3 months post-discharge. Future studies should determine whether patients with persistently elevated biomarker levels after AKI are at increased cardiovascular risk.

 V0: AKIV3: AKIP valueV0: No AKIV3: No AKIP value
ST-2 (ng/mL)105.5 (51.5-306)28.3 (22.8-37.9)<0.0001 64.5 (33.4-184)25.2 (20.5-31.4)<0.0001
Galectin-3 (ng/mL)18.5 (13.2-26.1)17.5 (13.1-22.9)<0.000113.3 (10.5-17.1)15.1 (12.1-19.3)<0.0001

* Comparing V0 to V3 levels, by AKI status

Funding

  • NIDDK Support