The value of serum TIMP-2,HDAC4,and UAR in predicting postoperative acute kidney injury in patients with acute Stanford type A aortic dissection
Liu Xiaoyun
Yang Xiaohong
Zheng Xinglong
Guo Fengwei
Abstract：Objective To evaluate the predictive value of serum tissue inhibitor of metalloproteinase-2(TIMP-2),histone deacetylase 4(HDAC4),and uric acid(UA)/albumin(ALB)ratio(UAR)for acute kidney injury(AKI)in patients with acute Stanford type A aortic dissection(ATAAD)after surgery.Methods From December 2021 to December 2024,133 ATA AD patients who underwent Sun's surgery and 133 heart healthy examinees in our hospital were selected as the study subjects and included in the ATAAD group and heart healthy group,respectively.Among them,55 patients in the ATAAD group developed AKI after surgery and were included in the postoperative AKI group,while the remaining 78 patients were included in the postoperative normal group.The serum TIMP-2,HDAC4,and UAR were compared.Multivariate logistic re-gression was performed to analyze the influencing factors of AKI in ATAAD patients after Sun's surgery.The relative risk was performed to discuss the risk of AKI in high expression of TIMP-2,HDAC4,and UAR compared to low expression.ROC curve was used to analyze the value of TIMP-2,HDAC4,and UAR in predicting AKI in ATAAD patients after surgery.Results The ATAAD group had higher serum TIMP-2,HDAC4,and UAR than the heart healthy group(t/P=11.469/＜0.001,10.311/＜0.001,12.235/＜0.001).The postoperative AKI group had higher proportion of cases involving renal artery dissection,TIMP-2,HDAC4,UAR,and longer total extracorporeal circulation time than the postoperative normal group,and all of them were risk factors for AKI[OR(95％CI)=3.125(1.795-5.442),2.674(1.651-4.330),2.831(1.691-4.740),3.335(1.824-6.099),2.749(1.661-4.549)].Relative risk analysis showed that the risk of developing AKI after surgery in patients with high TIMP-2,HDAC4,and UAR was 2.343 times,2.269 times,and 3.457 times higher than that in patients with low levels.The AUCs of TIMP-2,HDAC4,UAR and the combination of the three for predicting AKI after Sun's surgery in patients with ATAAD were 0.833,0.847,0.832 and 0.963,respectively.The combination of the three was superior to the AUCs of TIMP-2,HDAC4 and UAR alone(Z=3.366,3.236,3.391,P=0.001,0.001,0.001).Conclusion Serum TIMP-2,HDAC4,and UAR are elevated,and their union has high value in predicting postoperative AKI in ATAAD patients.
Keywords：Acute Stanford type A aortic dissectionAcute kidney injuryTissue inhibitor of metalloproteinase-2Histone deacetylase 4Uric acid/albumin ratio
Publication Date：2025-12-18
Online Publishing Date：2026-01-08(First online date of this platform, not the publication date of the document)
Pages：6( 1440-1445 )