Homoarginine, kidney function and cardiovascular mortality risk

Homoarginine is a novel biomarker for cardiovascular diseases. In the present large cohort study, we evaluate how homoarginine is linked to kidney function and examine the potential interaction of homoarginine and kidney function as predictors of cardiovascular outcomes. Serum homoarginine (mean: 2....

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Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2014-03, Vol.29 (3), p.663-671
Main Authors: Tomaschitz, Andreas, Meinitzer, Andreas, Pilz, Stefan, Rus-Machan, Jutta, Genser, Bernd, Drechsler, Christiane, Grammer, Tanja, Krane, Vera, Ritz, Eberhard, Kleber, Marcus E, Pieske, Burkert, Kraigher-Krainer, Elisabeth, Fahrleitner-Pammer, Astrid, Wanner, Christoph, Boehm, Bernhard O, März, Winfried
Format: Article
Language:English
Subjects:
Aged
Biomarkers - blood
Cohort Studies
Female
Glomerular Filtration Rate
Heart Failure - blood
Heart Failure - etiology
Heart Failure - mortality
Homoarginine - blood
Humans
Kidney Diseases - blood
Kidney Diseases - complications
Kidney Diseases - mortality
Male
Middle Aged
Mortality
Proportional Hazards Models
Risk Factors
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Summary:Homoarginine is a novel biomarker for cardiovascular diseases. In the present large cohort study, we evaluate how homoarginine is linked to kidney function and examine the potential interaction of homoarginine and kidney function as predictors of cardiovascular outcomes. Serum homoarginine (mean: 2.41 ± 1.05 µmol/L), cystatin C and creatinine-based estimated GFR (eGFR, mean: 86.2 ± 23.0 mL/min per 1.73 m(2)) were measured in 3037 patients (mean age: 62.8 ± 10.6 years; 31.5% women) who were referred to coronary angiography. Homoarginine was positively associated with eGFR (age- and gender-adjusted partial correlation coefficient: 0.20, P < 0.001); using multiple regression analysis, eGFR emerged as an independent predictor of serum homoarginine (β = 0.10, SE 0.01, P < 0.001). Overall cardiovascular mortality was 18.5% (563 cardiovascular deaths) after 9.9 years. Multivariate Cox proportional hazard analysis revealed that compared with participants in the highest gender-specific homoarginine tertile, those in the lowest tertile were at increased risk of cardiovascular death [multivariate-adjusted HR 1.47; 95% confidence interval (95% CI) 1.15-1.87, P = 0.002]. After adjustment for confounders, both homoarginine and eGFR were associated independently with cardiovascular mortality, with a strong synergistic interaction (P for interaction 0.005). After stratifying the cohort into persons with eGFRs
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/gft512