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Abstract: TH-PO788

Protein Biomarkers Associated With Cardiovascular Events in Older People With Advanced CKD: Results From the EQUAL Study

Session Information

Category: Geriatric Nephrology

  • 1200 Geriatric Nephrology

Authors

  • Hayward, Samantha JL, University of Bristol Translational Health Sciences, Bristol, England, United Kingdom
  • Chesnaye, Nicholas C., ERA-EDTA Registry, Amsterdam, Noord-Holland, Netherlands
  • Hole, Barnaby D., Population health sciences, Bristol Medical School, Bristol, United Kingdom
  • Aylward, Ryan E., Population health sciences, Bristol Medical School, Bristol, United Kingdom
  • Meuleman, Yvette, Leids Universitair Medisch Centrum Afdeling Klinische Epidemiologie, Leiden, Zuid-Holland, Netherlands
  • Torino, Claudia, Istituto di Fisiologia Clinica Consiglio Nazionale delle Ricerche Sezione di Reggio Calabria, Reggio Calabria, Calabria , Italy
  • Porto, Gaetana, GOM Bianchi Melacrino Morelli, Reggio Calabria,, Reggio Calabria, Italy
  • Szymczak, Maciej, Uniwersytet Medyczny im Piastow Slaskich we Wroclawiu Katedra i Klinika Nefrologii i Medycyny Transplantacyjnej, Wroclaw, Dolnośląski, Poland
  • Drechsler, Christiane, Division of Nephrology, University Hospital of Wurzburg,, Wurzburg, Germany
  • Dekker, Friedo W., Leids Universitair Medisch Centrum Afdeling Klinische Epidemiologie, Leiden, Zuid-Holland, Netherlands
  • Evans, Marie, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Jager, Kitty J., ERA-EDTA Registry, Amsterdam, Noord-Holland, Netherlands
  • Wanner, Christoph, Division of Nephrology, University Hospital of Wurzburg,, Wurzburg, Germany
  • Caskey, Fergus, Population health sciences, Bristol Medical School, Bristol, United Kingdom
Background

Cardiovascular disease is the leading cause of morbidity and mortality in people with chronic kidney disease (CKD). We investigated a panel of proteins associated with inflammatory and cardiovascular disease to determine their potential as biomarkers for major cardiovascular events (MACE) amongst individuals with CKD.

Methods

The EQUAL study enrolled people aged ≥65 years with eGFR ≤20. EQUAL recruits were split into Discovery (n=611) and Replication cohorts (n=292). Baseline blood samples were tested for 184 proteins using OLINK proximity extension assay technology. Cox proportional hazard models adjusted for age, sex, eGFR and country were used to determine the risk of MACE. Proteins with false discovery rate (FDR) values <0.05 in the Discovery cohort were considered significant and were tested in the Replication cohort. Sensitivity analyses, adjusting for traditional (hypertension, diabetes, previous myocardial infarction, cholesterol, smoking and body mass index) and CKD-specific (calcium, phosphate and PTH) risk factors for MACE, were performed.

Results

During a median follow-up of 2.9 years 325 people (36%) had MACE. 63 proteins were associated with MACE in the Discovery cohort (FDR p values <0.05); 12 of these proteins had similar effect sizes in the Replication cohort (Figure 1). Tenascin, Vascular cell adhesion protein 1 (VCAM1), V-set and Immunoglobulin Domain containing protein 2 (VSIG2) and Fibroblast growth factor 23 (FGF23) maintained their association with MACE after adjustment for traditional and CKD-specific risk factors.

Conclusion

Increased levels of Tenascin, VCAM1, VSIG2 and FGF23 were associated with an increased risk of MACE in older people with advanced CKD. Our findings highlight VSIG2 as a new potential cardiovascular biomarker and corroborate those of previous studies linking Tenascin, VCAM1 and FGF23 with MACE in people with CKD.