新蝶呤与肾移植患者的心血管事件及全因死亡率相关。
Neopterin is associated with cardiovascular events and all-cause mortality in renal transplant patients.
作者信息
Pihlstrøm Hege, Mjøen Geir, März Winfried, Olav Dahle Dag, Abedini Sadollah, Holme Ingar, Fellström Bengt, Jardine Alan, Pilz Stefan, Holdaaas Hallvard
机构信息
Department of Organ Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway.
出版信息
Clin Transplant. 2014 Jan;28(1):111-9. doi: 10.1111/ctr.12285. Epub 2013 Dec 24.
BACKGROUND
Inflammatory markers show significant associations with cardiovascular events and all-cause mortality after kidney transplantation. Neopterin, reflecting interferon-γ-release, may better reflect the proinflammatory state of recipients than less specific markers.
METHODS
Kidney transplant recipients in the Assessment of LEscol in Renal Transplant (ALERT) trial were examined and investigated for an association between serum neopterin and subsequent clinical events: graft loss, major cardiovascular events (MACE) and all-cause mortality.
RESULTS
After adjustment for established and emerging risk factors neopterin expressed as neopterin-to-creatinine ratio was significantly associated with MACE (p = 0.009) and all-cause mortality (p = 0.002). Endpoints were more frequent with increasing quartiles of neopterin-to-creatinine ratio. The incidence rates of MACE and all-cause mortality were significantly increased in the upper quartiles compared with the first.
CONCLUSIONS
This long-term prospective analysis in stable kidney allograft recipients suggests that neopterin is associated with long-term risk of cardiovascular events and all-cause mortality, but not renal outcomes.
背景
炎症标志物与肾移植后的心血管事件和全因死亡率显著相关。反映干扰素-γ释放的新蝶呤可能比特异性较低的标志物能更好地反映受者的促炎状态。
方法
对肾移植评估（ALERT）试验中的肾移植受者进行检查，以研究血清新蝶呤与随后临床事件（移植肾丢失、主要心血管事件[MACE]和全因死亡率）之间的关联。
结果
在对已确定和新出现的危险因素进行调整后，以新蝶呤与肌酐比值表示的新蝶呤与MACE（p = 0.009）和全因死亡率（p = 0.002）显著相关。随着新蝶呤与肌酐比值四分位数的增加，终点事件更频繁。与第一四分位数相比，上四分位数的MACE和全因死亡率发生率显著增加。
结论
这项对稳定肾移植受者的长期前瞻性分析表明，新蝶呤与心血管事件和全因死亡率的长期风险相关，但与肾脏结局无关。
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