Serum Soluble Suppression of Tumorigenicity-2 Levels Predict Cardiovascular Events in Patients Undergoing Incident Peritoneal Dialysis: A Prospective Cohort Study.

IF 2.3 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Kidney & blood pressure research Pub Date : 2024-01-01 Epub Date: 2024-07-31 DOI:10.1159/000540657
Yunyun Zhang, Qijiang Xu, Xiaofang Wu, Li Pu, Zhiyun Zang, Xiaoxiao Xia, Niya Ma, Zi Li
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Abstract

Introduction: Biomarkers are urgently required to identify peritoneal dialysis (PD) patients at risk of cardiovascular (CV) events. This study aimed to investigate the predictive value of soluble suppression of tumorigenicity-2 (sST2) for CV events in patients undergoing incident PD.

Methods: In this prospective cohort study, incident PD patients were enrolled. Blood samples to measure sST2 levels were obtained before PD catheter implantation. The patients underwent a standard peritoneal equilibration test (PET) after initiation of PD for 4-6 weeks. The sST2 levels in both serum and dialysate were determined using enzyme-linked immunosorbent assay. CV events were recorded during the follow-up period.

Results: A total of 137 patients were enrolled. During the follow-up period of 17.3 months, 49 (35.76%) patients experienced CV events. When patients were dichotomized based on the median values and the calculated cutoff values of sST2, the higher sST2 group had 2.980- and 3.048-fold increased risks of CV events, respectively, when compared with the lower sST2 group. Moreover, the prognostic value of sST2 remained significant as a continuous variable (per 1 standard deviation increase, hazard ratio [HR] = 1.037, 95% confidence interval [CI] 1.010-1.066, p = 0.008). N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were found to indicate a higher risk only when dichotomized based on the calculated cutoff values. Furthermore, serum sST2 and NT-proBNP levels simultaneously above the calculated cutoff values were associated with a higher risk of CV events (HR = 3.398, 95% CI 1.813-6.367, p < 0.001).

Conclusion: Baseline serum sST2 level is an independent predictor of the risk of CV events in patients receiving incident PD, and in combination with NT-proBNP level, it can provide a more accurate predictive value.

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血清 sST2 水平可预测腹膜透析患者的心血管事件:一项前瞻性队列研究。
简介:腹膜透析(PD)患者发生心血管事件的风险急需生物标志物来识别。本研究旨在探讨可溶性致瘤抑制因子-2(sST2)对腹膜透析患者心血管事件的预测价值:在这项前瞻性队列研究中,入组了事件性肺结核患者。方法:在这项前瞻性队列研究中,研究人员招募了腹腔镜手术患者,在植入腹腔镜导管前采集血液样本以测量sST2水平。开始腹膜透析后,患者接受为期 4-6 周的标准腹膜平衡试验(PET)。使用酶联免疫吸附试验测定血清和透析液中的 sST2 水平。随访期间记录了心血管事件:结果:共有 137 名患者入选。在 17.3 个月的随访期间,49 名患者(35.76%)发生了心血管事件。根据 sST2 的中位值和计算出的临界值对患者进行二分,与 sST2 较低的患者相比,sST2 较高的患者发生 CV 事件的风险分别增加了 2.980 倍和 3.048 倍。此外,作为一个连续变量,sST2 的预后价值仍然显著(每增加 1 个标准差,危险比 [HR] =1.037,95% 置信区间 [CI] 1.010-1.066,P=0.008)。只有在根据计算的临界值进行二分时,才会发现 N 端前脑钠肽 (NT-proBNP) 水平预示着更高的风险。此外,血清 sST2 和 NT-proBNP 水平同时高于计算出的临界值与较高的心血管事件风险相关(HR=3.398,95% CI 1.813-6.367,P<0.001):结论:血清 sST2 基线水平可独立预测接受事件性帕金森病治疗的患者发生心血管事件的风险,与 NT-proBNP 水平联合使用可提供更准确的预测值。
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来源期刊
Kidney & blood pressure research
Kidney & blood pressure research 医学-泌尿学与肾脏学
CiteScore
4.80
自引率
3.60%
发文量
61
审稿时长
6-12 weeks
期刊介绍: This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.
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