Kidney Week

Abstract: FR-PO760

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

Session Information

• Hypertension and CVD: Clinical, Outcomes, Trials
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

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

Authors

• Salzinger, Barbara, Karolinska Institutet, Stockholm, Stockholm, Sweden

Barbara Salzinger,

• Lundwall, Kristina, Karolinska Institutet, Stockholm, Stockholm, Sweden

Kristina Lundwall,

• Evans, Marie, Karolinska Institutet, Stockholm, Stockholm, Sweden

Marie Evans,

• Mortberg, Josefin LG, Uppsala Universitet, Uppsala, Sweden

Josefin LG Mortberg,

• Wallen, Hakan, Karolinska Institutet, Stockholm, Stockholm, Sweden

Hakan Wallen,

• Jernberg, Tomas, Karolinska Institutet, Stockholm, Stockholm, Sweden

Tomas Jernberg,

• Kahan, Thomas, Karolinska Institutet, Stockholm, Stockholm, Sweden

Thomas Kahan,

• Lundman, Pia, Karolinska Institutet, Stockholm, Stockholm, Sweden

Pia Lundman,

• Lindahl, Bertil, Uppsala Universitet, Uppsala, Sweden

Bertil Lindahl,

• Spaak, Jonas, Karolinska Institutet, Stockholm, Stockholm, Sweden

Jonas Spaak,

• Jacobson, Stefan H., Karolinska Institutet, Stockholm, Stockholm, Sweden

Stefan H. Jacobson,

Background

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.

Methods

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.

Results

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+.

Conclusion

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.

Funding

• Commercial Support –