Acute kidney injury (AKI) after cardiac surgery is associated with increased short- and long-term mortality. Inflammation, oxidative stress, and endothelial dysfunction and damage play important roles in the development of AKI. High-density lipoproteins (HDLs) have anti-inflammatory and antioxidant properties and improve endothelial function and repair. Statins enhance HDL's anti-inflammatory and antioxidant capacities. We hypothesized that a higher preoperative HDL cholesterol concentration is associated with decreased AKI after cardiac surgery and that perioperative statin exposure potentiates this association.
We tested our hypothesis in 391 subjects from a randomized clinical trial of perioperative atorvastatin to reduce AKI after cardiac surgery. A 2-component latent variable mixture model was used to assess the association between preoperative HDL cholesterol concentration and postoperative change in serum creatinine, adjusted for known AKI risk factors and suspected confounders. Interaction terms were used to examine the effects of preoperative statin use, preoperative statin dose, and perioperative atorvastatin treatment on the association between preoperative HDL and AKI. A higher preoperative HDL cholesterol concentration was independently associated with a decreased postoperative serum creatinine change (P=0.02). The association between a high HDL concentration and an attenuated increase in serum creatinine was strongest in long-term statin-using patients (P=0.008) and was further enhanced with perioperative atorvastatin treatment (P=0.004) and increasing long-term statin dose (P=0.003).
A higher preoperative HDL cholesterol concentration was associated with decreased AKI after cardiac surgery. Preoperative and perioperative statin treatment enhanced this association, demonstrating that pharmacological potentiation is possible during the perioperative period.
URL: http://www.clinicaltrials.gov. Unique Identifier: NCT00791648.
Pharmacology, Toxicology and Pharmaceutical Science
1
2%
Other
5
8%
Unknown
31
53%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 16. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 July 2025.
All research outputs
#2,946,131
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Outputs from Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease
#2,534
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Outputs of similar age
#48,932
of 491,611 outputs
Outputs of similar age from Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease
#57
of 208 outputs
Altmetric has tracked 34,376,207 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,010 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 32.5. This one has done well, scoring higher than 76% of its peers.
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We're also able to compare this research output to 208 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.
