Kidney Week

Abstract: SA-OR024

Monocyte Chemoattractant Protein-1 (MCP-1) Is Associated with Atherosclerotic (ASCV) Events and Death in CKD

Session Information

• Mineral Disease: Bones, Vessels, Stones
  November 04, 2017 | Location: Room 273, Morial Convention Center
  Abstract Time: 05:06 PM - 05:18 PM

Category: Mineral Disease

• 1205 Vascular Calcification

Authors

• Tio, Maria Clarissa, University of Texas Southwestern Medical Center, Dallas, Texas, United States

Maria Clarissa Tio, MD



• Gregg, Lucile Parker, University of Texas Southwestern Medical Center, Dallas, Texas, United States

Lucile Parker Gregg,

• Li, Xilong, University of Texas Southwestern Medical Center, Dallas, Texas, United States

Xilong Li,

• Adams-Huet, Beverley, University of Texas Southwestern Medical Center, Dallas, Texas, United States

Beverley Adams-Huet,

• Delemos, James, University of Texas Southwestern Medical Center, Dallas, Texas, United States

James Delemos,

• Hedayati, Susan, University of Texas Southwestern Medical Center, Dallas, Texas, United States

Susan Hedayati,

Background

MCP-1, an inflammatory chemokine involved in atherogenesis, is associated with CV events in individuals with known coronary artery disease. Few data exist regarding its association with hard outcomes in CKD.

Methods

We studied 3,257 participants of the Dallas Heart Study, 285 (8.8%) of whom had CKD (eGFR <60 mL/min/1.73m² or albuminuria), followed for a median of 12.5 years for all-cause death, global CV events (CV death, MI, stroke, CV revascularization, hospitalization for heart failure or atrial fibrillation), and ASCV events (CV death, MI, stroke, CV revascularization). Cox proportional hazards regression assessed associations between log MCP-1 levels and outcomes, unadjusted and adjusted for traditional CV risk factors (age, sex, race, hypertension, diabetes, current smoking, total and HDL cholesterol) and eGFR.

Results

There were 327 deaths, 287 global CV and 228 ASCV events in the entire cohort. In the CKD group, there were 97 (34%) deaths, 76 (34.5%) global CV and 62 (27.9%) ASCV events. Median (IQR) MCP-1 was 164.7 (120.3, 220.9) pg/mL in non-CKD vs. 192.2 (143.6, 269.8) in CKD individuals, P<0.001, and negatively correlated with eGFR, r=-0.23, P<0.0001. In the CKD group, MCP-1 was associated with death (HR 1.96, 95% CI 1.35-2.85) and ASCV events (HR 1.72, 95% CI 1.04-2.87) but not global CV events in unadjusted models (Figure). Adjustment for CV risk factors attenuated the association between MCP-1 and ASCV events, but the association with death remained significant in non-CKD (aHR=1.65, 95% CI 1.32-2.07) and CKD (aHR=1.49, 95% CI 1.01-2.19) groups. There were no significant CKDxMCP-1 interactions on outcomes.

Conclusion

While MCP-1 does not predict global CV and ASCV events after adjusting for CV risk factors, it is an independent predictor of all-cause death in both CKD and non-CKD individuals. Future directions include exploring its inclusion in outcome prediction models in the CKD population.

Funding

• NIDDK Support – J. A. de Lemos has received grant support and consulting income from Roche Diagnostics and Abbott Diagnostics and has served on endpoint committees for Siemen’s Health Care Diagnostics and Radiometer.