Abstract
Abstract 409: Statin Dose Is Associated With Improved HDL Anti-inflammatory Capacity In Cardiac And Vascular Surgery Patients; Possible Mechanism For Statin Mediated Enhancement Of The Association Between Higher HDL And Less Kidney Injury After Surgery
Arteriosclerosis, thrombosis, and vascular biology, Vol.43(Suppl_1)
05/2023
DOI: 10.1161/atvb.43.suppl_1.409
Abstract
Abstract only
Introduction:
Postoperative acute kidney injury (AKI) is associated with chronic kidney disease (CKD) development and advancement. A higher preoperative high-density lipoprotein (HDL) concentration is associated with less postoperative AKI. Statin exposure, especially long-term exposure, strengthens the association between higher HDL and less postoperative AKI. However, three randomized trials of perioperative statin treatment did not prevent AKI. In animal models, HDL prevents AKI primarily by suppressing renal endothelial intercellular adhesion molecule-1 (ICAM-1). We hypothesized that HDL from surgery patients on higher long-term statin doses would have improved capacity to suppress endothelial ICAM-1 expression. Further, we hypothesized that patients with higher
in vitro
HDL capacity to suppress ICAM-1 would have lower plasma sICAM-1 concentrations after surgery and less AKI.
Methods:
We recruited 100 adults undergoing major surgery on the heart or large blood vessels. ApoB-depleted serum was incubated with HUVEC cells for 30min. Then, 8 ng/mL TNF-α was added for 5hr. RT-PCR quantified HUVEC ICAM-1 mRNA. An ELISA assay measured sICAM-1 concentrations. AKI was defined by KDIGO serum creatinine-based criteria.
Results:
HDL-C did not correlate with HDL ICAM-1 suppression (Spearman’s R=0.05, p=0.64). Apolipoprotein A-I concentration did correlate with HDL ICAM-1 suppression (Spearman’s R= 0.29, p=0.004). Higher HDL capacities to suppress ICAM-1
in vitro
were correlated with lower plasma sICAM-1 (Spearman’s R= -0.30, p=0.003). After adjustment for AKI risk factors, higher HDL-C was not associated with AKI (OR 1.03 (95% CI 0.98-1.08), p=0.19). In contrast, a higher HDL capacity to suppress ICAM-1 was independently associated with lower odds of AKI (OR 0.88 (95% CI 0.80-0.98), p=0.016). Further, higher long-term statin dose was associated with higher HDL capacity to suppress ICAM-1 (p=0.045).
Conclusions:
Cardiac and vascular surgery patients with higher HDL capacity to suppress endothelial ICAM-1 have lower plasma sICAM concentrations after surgery and a lower risk of postoperative AKI. Higher long-term statin dose is associated with higher HDL endothelial cell ICAM-1 suppression capacity in these patients.
Details
- Title: Subtitle
- Abstract 409: Statin Dose Is Associated With Improved HDL Anti-inflammatory Capacity In Cardiac And Vascular Surgery Patients; Possible Mechanism For Statin Mediated Enhancement Of The Association Between Higher HDL And Less Kidney Injury After Surgery
- Creators
- Zoe M Leuthner - Alabama College of Osteopathic MedicinePatricia G Yancey - Vanderbilt UniversityMacrae F Linton - Vanderbilt UniversityLoren E Smith - Vanderbilt University
- Resource Type
- Abstract
- Publication Details
- Arteriosclerosis, thrombosis, and vascular biology, Vol.43(Suppl_1)
- DOI
- 10.1161/atvb.43.suppl_1.409
- ISSN
- 1079-5642
- eISSN
- 1524-4636
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS; PHILADELPHIA
- Language
- English
- Date published
- 05/2023
- Academic Unit
- Anesthesia
- Record Identifier
- 9984958338602771
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