Abstract | BACKGROUND AND AIMS: METHODS: The presence of calcified or non-calcified atherosclerotic plaques was assessed in 1043 stage 3 to 5D CKD patients from The NEFRONA Study. Biochemical measurements and OPG, OPN and sTWEAK serum levels were analyzed. Patients were followed for cardiovascular outcomes (41 ± 16 months). RESULTS: At recruitment, 26% of CKD patients had VC. The adjusted odds ratios for having VC were 2.22 (1.32-3.75); p=.003 for OPG, and 0.45 (0.24-0.84); p=.01 for sTWEAK concentrations. After follow-up, 95 CV events occurred. In a Cox model, patients with OPG or OPN above and sTWEAK below their optimal cut-off points had an adjusted higher risk of cardiovascular events [HR: 2.10 (1.49-3.90); p=.02; 1.65 (1.02-2.65); p=.04; 2.05 (1.28-3.29), p=.003; respectively]. When CKD patients were grouped according to the number of biomarkers above (OPG and OPN) or below (sTWEAK) their cut-off points, the combination of these biomarkers showed the highest risk for cardiovascular events [HR: 9.46 (3.80-23.5) p < .001]. A composite score of these three biomarkers increased the C-statistic and net reclassification index beyond conventional risk factors and VC. CONCLUSIONS: The combination of OPG, OPN and sTWEAK increased the predictability of cardiovascular outcomes.
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Authors | Milica Bozic, Nerea Méndez-Barbero, Carmen Gutiérrez-Muñoz, Angels Betriu, Jesús Egido, Elvira Fernández, Jose L Martín-Ventura, Jose M Valdivielso, Luis M Blanco-Colio, investigators from the NEFRONA study |
Journal | Atherosclerosis
(Atherosclerosis)
Vol. 270
Pg. 13-20
(03 2018)
ISSN: 1879-1484 [Electronic] Ireland |
PMID | 29407881
(Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2018 Elsevier B.V. All rights reserved. |
Chemical References |
- Biomarkers
- Cytokine TWEAK
- Osteoprotegerin
- SPP1 protein, human
- TNFRSF11B protein, human
- TNFSF12 protein, human
- Osteopontin
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Topics |
- Aged
- Biomarkers
(blood)
- Cardiovascular Diseases
(blood, diagnosis, mortality)
- Cytokine TWEAK
(blood)
- Female
- Humans
- Male
- Middle Aged
- Osteopontin
(blood)
- Osteoprotegerin
(blood)
- Predictive Value of Tests
- Prevalence
- Prognosis
- Prospective Studies
- Renal Insufficiency, Chronic
(blood, diagnosis, mortality)
- Risk Assessment
- Risk Factors
- Spain
(epidemiology)
- Time Factors
- Vascular Calcification
(blood, diagnosis, mortality)
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