Abstract: SA-PO792
CXCL12 and Fractalkine Predict Heart Failure in CKD Patients: The CRIC Study
Session Information
- Hypertension and CVD: Mechanisms
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1503 Hypertension and CVD: Mechanisms
Authors
- Marques, Mariana Fragao, Centro Hospitalar Universitario de Sao Joao, Porto, Portugal
- Borges Canha, Marta, Centro Hospitalar Universitario de Sao Joao, Porto, Portugal
- Ravi, Katherine Scovner, Brigham and Women's Hospital, Boston, Massachusetts, United States
- McCausland, Finnian R., Brigham and Women's Hospital, Boston, Massachusetts, United States
Background
Heart Failure (HF) is common and associated with higher mortality in patients with Chronic Kidney Disease (CKD). Inflammation is thought to play a role in HF development, prompting us to explore the association of CXCL12 and fractalkine (T cell and monocyte chemokines, respectively) with incident HF in the Chronic Renal Insufficiency Cohort (CRIC).
Methods
This study included 3478 patients with available baseline measurements of CXCL12 and Fractalkine. Multivariable Cox and logistic regression models were fit to assess the association of each biomarker (log-transformed and categories) with baseline B-type Natriuretic Peptide (BNP) levels and Left Ventricular Mass Index (LVMI) measured at year 1, both defined as categorical variables above median, and incident HF.
Results
In fully adjusted analyses, higher CXCL12 and fractalkine levels were associated with higher baseline BNP – Odds Ratio (OR) 1.27 [95% Confidence Interval (CI) 1.17 – 1.38] and OR 1.22 [1.11 – 1.34], respectively. Raised CXCL12 and fractalkine were associated with increased LVMI at year 1 of follow-up, independent of patient demographics and renal function – OR 95% CI 1.10 [1.01 – 1.21] and 1.13 [1.03 – 1.24], correspondingly. Both biomarkers predicted incident HF, regardless of patient demographics, renal function, comorbidities, medication and sodium and phosphate levels – Hazard Ratio (HR) 95% CI 1.21 [1.07 – 1.37] for CXCL12 and 1.15 [1.00 – 1.31] for fractalkine. Results were significant only for the highest quartiles of the biomarkers when analysed as categorical variables.
Conclusion
Higher levels of CXCL12 and fractalkine are independently associated with higher baseline BNP, LVMI at 1 year, and incident HF hospitalization. Whether interventions that target these pathways can reduce incident HF among patients with CKD remains to be determined.