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Abstract: FR-PO760

Impact of Kidney Function on the Association Between Selected Proteomic Biomarkers and Cardiovascular Events and Mortality

Session Information

Category: Hypertension and CVD

  • 1502 Hypertension and CVD: Clinical‚ Outcomes‚ and Trials


  • Salzinger, Barbara, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Lundwall, Kristina, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Evans, Marie, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Mortberg, Josefin LG, Uppsala Universitet, Uppsala, Sweden
  • Wallen, Hakan, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Jernberg, Tomas, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Kahan, Thomas, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Lundman, Pia, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Lindahl, Bertil, Uppsala Universitet, Uppsala, Sweden
  • Spaak, Jonas, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Jacobson, Stefan H., Karolinska Institutet, Stockholm, Stockholm, Sweden

The link between chronic kidney disease (CKD) and the high burden of cardiovascular disease remains unclear. We aimed to explore whether CKD G3+ (eGFR<60 ml/min/1.73m2) modified the association between selected biomarkers reflecting systemic inflammation, endothelial activation, angiogenesis, and vascular calcification, and major adverse cardiovascular events (MACE) and mortality in patients admitted to hospital with an acute coronary syndrome.


In all, 1293 patients 2008-2015 hospitalized with an acute coronary syndrome registered in the SWEDEHEART registry were followed until Dec 31, 2017. Thirteen biomarkers were a priori identified and analyzed with two proteomic methods, the proximity extension assay technology and multiple reaction monitoring mass spectrometry. The primary outcome (MACE+) was a composite of the first event of readmission for myocardial infarction, heart failure, ischemic stroke or death from any cause. Adjusted Cox proportional hazard models with an interaction term for CKD G3+ was used.


Six of the biomarkers (ESM-1 (endocan), IL-1Ra, FGF-23, PlGF, TIM1 and VEGF-A) showed a significant association with MACE+ in the Cox regression models adjusted for age, gender, diabetes, smoking and CKD. Of these biomarkers, only FGF-23 remained independently associated after additional adjustment for the other biomarkers (Figure). None of the 13 selected biomarkers showed significant interaction with CKD G3+.


In patients with acute coronary syndrome, FGF-23, ESM-1, IL-1ra, PlGF, TIM1 and VEGF-A were associated with cardiovascular events and mortality. FGF-23 was independently associated with MACE and death regardless of presence of CKD or not.


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