{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:13:23Z","timestamp":1791504803452,"version":"4.3.4"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","license":[{"start":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T00:00:00Z","timestamp":1633392000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2021,10,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Acute kidney injury (AKI) affects up to 30% of patients undergoing cardiac surgery, leading to increased in-hospital and long-term morbidity and mortality. Teprasiran is a novel small interfering RNA that temporarily inhibits p53-mediated cell death that underlies AKI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>This prospective, multicenter, double-blind, randomized, controlled phase 2 trial evaluated the efficacy and safety of a single 10 mg\/kg dose of teprasiran versus placebo (1:1), in reducing the incidence, severity, and duration of AKI after cardiac surgery in high-risk patients. The primary end point was the proportion of patients who developed AKI determined by serum creatinine by postoperative day 5. Other end points included AKI severity and duration using various prespecified criteria. To inform future clinical development, a composite end point of major adverse kidney events at day 90, including death, renal replacement therapy, and \u226525% reduction of estimated glomerular filtration rate was assessed. Both serum creatinine and serum cystatin-C were used for estimated glomerular filtration rate assessments.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              A total of 360 patients were randomly assigned in 41 centers; 341 dosed patients were 73\u00b17.5 years of age (mean\u00b1SD), 72% were men, and median European System for Cardiac Operative Risk Evaluation score was 2.6%. Demographics and surgical parameters were similar between groups. AKI incidence was 37% for teprasiran- versus 50% for placebo-treated patients, a 12.8% absolute risk reduction,\n              <jats:italic>P<\/jats:italic>\n              =0.02; odds ratio, 0.58 (95% CI, 0.37\u20130.92). AKI severity and duration were also improved with teprasiran: 2.5% of teprasiran- versus 6.7% of placebo-treated patients had grade 3 AKI; 7% teprasiran- versus 13% placebo-treated patients had AKI lasting for 5 days. No significant difference was observed for the major adverse kidney events at day 90 composite in the overall population. No safety issues were identified with teprasiran treatment.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The incidence, severity, and duration of early AKI in high-risk patients undergoing cardiac surgery were significantly reduced after teprasiran administration. A phase 3 study with a major adverse kidney event at day 90 primary outcome that has recently completed enrollment was designed on the basis of these findings (NCT03510897).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT02610283.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.120.053029","type":"journal-article","created":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T09:25:23Z","timestamp":1630661123000},"page":"1133-1144","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":95,"title":["Teprasiran, a Small Interfering RNA, for the Prevention of Acute Kidney Injury in High-Risk Patients Undergoing Cardiac Surgery: A Randomized Clinical Study"],"prefix":"10.1161","volume":"144","clinical-trial-number":[{"clinical-trial-number":"nct02610283","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1007-2871","authenticated-orcid":true,"given":"Matthias","family":"Thielmann","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-Essen, Germany (M.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3129-1870","authenticated-orcid":true,"given":"David","family":"Corteville","sequence":"additional","affiliation":[{"name":"Sands Constellation Heart Institute, Rochester Regional Health, Rochester, NY (D.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor","family":"Szabo","sequence":"additional","affiliation":[{"name":"Central German Heart Center University Hospital Halle (Saale), University Clinic and Polyclinic for Cardiac Surgery, Halle, Germany (G.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhav","family":"Swaminathan","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Duke University Medical Center, Durham, NC (M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Lamy","sequence":"additional","affiliation":[{"name":"David Braley Cardiac, Vascular and Stroke Research Institute, McMaster University, Hamilton, ON, Canada (A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9440-6196","authenticated-orcid":true,"given":"Lukas J.","family":"Lehner","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Medical Intensive Care, Charit\u00e9 Universit\u00e4tsmedizin, Berlin, Germany (L.J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6077-7263","authenticated-orcid":true,"given":"Craig D.","family":"Brown","sequence":"additional","affiliation":[{"name":"New Brunswick Heart Centre, The Saint John Regional Hospital, NB, Canada (C.D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Noiseux","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Montreal Hospital Center, CHUM Research Center, Montreal, QC, Canada (N.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed G.","family":"Atta","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Johns Hopkins School of Medicine, Baltimore, MD (M.G.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2798-3049","authenticated-orcid":true,"given":"Elizabeth C.","family":"Squiers","sequence":"additional","affiliation":[{"name":"Coastal Vista Consulting LLC, Half Moon Bay, CA (E.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9916-3410","authenticated-orcid":true,"given":"Shai","family":"Erlich","sequence":"additional","affiliation":[{"name":"Nephrology Division, Department of Medicine, Indiana University School of Medicine; Indiana Center for Biological Microscopy, Indianapolis (B.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Rothenstein","sequence":"additional","affiliation":[{"name":"Quark Pharmaceuticals, Inc, Newark, CA (S.E. 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