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Demonstrating the Clinical Power of Senescence Biomarkers in Cardiac Surgery

As a pre-operative risk prediction score, AKI-Sapere is comprised of senescence biomarkers and small subset of clinical variables that, together, stratify patients by risk of acute kidney injury (AKI) associated with cardiac surgery.  Although AKI is common, affecting 30% of patients, clinicians are unable to accurately target patients for prevention and early treatment because standard pre-operative risk factors like chronological age, co-morbidities and baseline kidney function too often fail to correlate with post-operative renal injury. AKI-Sapere empowers physicians with insights about patient's physiologic reserve and need for peri-operative interventions and monitoring that will improve outcomes and save costs.

AKI-Sapere Components

Senescence 

Biomarkers

Biomarkers of senescence drive risk prediction for AKI

(subset of PR-Sapere panel)

Enhancing

Variables

AKI-Sapere includes two clinical variables that strengthen the biomarker-based predictive model 

In Sapere Bio's discovery study at Duke and Johns Hopkins, common renal biomarkers (sCysC, KIM-1, TIMP-2, L-FABP1, albumin, B2M, NGAL, OPN, UMOD) did not predict AKI before surgery and are therefore not included in AKI-Sapere.

AKI-Sapere Efficacy

Sapere Bio's real-world, observational discovery study in CABG demonstrated that even though clinicians treat at-risk patients differently, they miss most patients who are truly at-risk since loss of physiologic reserve is not obvious and cannot be accurately deduced from a chart or clinical exam. Using baseline sCr, only 15% of patients who eventually develop AKI were identifiable pre-operatively as high-risk (<5% of all patients).  In contrast, by measuring AKI-Sapere before surgery, clinicians can identify 80% of at-risk patients and personalize interventions to prevent AKI.

Ongoing AKI-Sapere Development

A multi-center clinical validation trial in CABG is ongoing. Additional studies and collaborations are under development to foster expedited physician uptake, guideline inclusion, and reimbursement.

 

Further, our discovery data suggests that AKI-Sapere can predict both risk of AKI and risk of ICU admission before cardiac catheterization/percutaneous coronary intervention (PCI).