• Sabry S Ayad, Thomas Beaver, David Corteville, Madhav Swaminathan, Ronald G Pearl, Shakil Aslam, Philipp Andreas Csomor, Gabriela Alperovich, and John Neylan.
• Outcomes Research Department, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: saayad@ccf.org.
• J. Thorac. Cardiovasc. Surg. 2024 Nov 25.

ObjectivesTo investigate the safety and efficacy of ANG-3777, a hepatocyte growth factor mimetic, in mitigating the risk of acute kidney injury (AKI) in patients undergoing cardiac surgery with cardiopulmonary bypass.MethodsIn this double-blind placebo-controlled study (GUARD), patients were randomized to receive intravenous ANG-3777 2 mg/kg or placebo once daily for 4 days. The primary endpoint was AKI severity, measured by mean area under the concentration-time curve on percent increase in serum creatinine from days 2 to 6. Secondary endpoints included the proportions of patients who developed major adverse kidney events by day 30 or 90 and the percentage of patients diagnosed with AKI through day 5.ResultsIn total, 259 patients received study treatment (ANG-3777, n = 129; placebo, n = 130). Through day 6, there was no significant difference in least-squares mean change in serum creatinine between ANG-3777 and placebo (1.1%; 95% CI, -6.2, 8.4; P = .77), or in proportions of patients who developed major adverse kidney events by day 30 (18.6% vs 16.2%; P = .60) or day 90 (14.7% vs 21.5%; P = .16). Similar proportions of patients were diagnosed with AKI through day 5 (ANG-3777, 47.3%; placebo, 48.5%); however, exploratory analysis revealed more patients diagnosed with AKI postoperatively showed signs of recovery following treatment with ANG-3777 than placebo. Overall, ANG-3777 was well tolerated, with similar incidences of treatment-emergent adverse events between treatment arms.ConclusionsFindings from this study do not support the efficacy of ANG-3777 in preventing the development of AKI following cardiopulmonary bypass.Copyright © 2024. Published by Elsevier Inc.

5 keywords...

hide…