Placental Growth Factor as a Predictor of Cardiovascular Events in Patients with CKD from the NARA-CKD Study
Placental Growth Factor as a Predictor of Cardiovascular Events in Patients with CKD from the NARA-CKD Study
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DOI：
10.1681/asn.2014080772
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发表时间：
2015-11-01
影响因子：
13.6
通讯作者：
Saito, Yoshihiko
中科院分区：
文献类型：
--
作者：
Matsui, Masaru;Uemura, Shiro;Saito, Yoshihiko
胎盘生长因子（PlGF）通过血管炎症和斑块不稳定而促进动脉粥样硬化形成。高水平的PIGF可能与死亡率和心血管疾病相关，但PIGF水平与CKD患者不良结局之间的关系尚不清楚。我们对2004年4月1日至2011年12月31日期间参加CKD动脉粥样硬化疾病风险管理新评估（NARA-CKD）研究的1351名连续CKD受试者进行了前瞻性队列研究。在中位随访3年期间，199名参与者死亡，383名发生心血管事件，定义为动脉粥样硬化疾病或需要住院治疗的心力衰竭。在校正分析中，死亡率和心血管风险在血清PIGF水平的每个连续四分位数中增加;风险比（死亡率和心血管风险的95%置信区间[95%asp]分别为1.59（0.83 ~ 3.16）和1.55第二四分位数分别为2.97（1.67 ~ 5.59）和3.39（2.20 ~ 5.41），第四四分位数分别为3.87（2.24 ~ 7.08）和8.42（5.54 ~ 13.3）。在研究期间，76.4%的患者在最高PIGF四分位数（19.6 pg/ml）和最低eGFR三分位数（
Placental growth factor (PIGF) contributes to atherogenesis through vascular inflammation and plaque destabilization. High levels of PIGF may be associated with mortality and cardiovascular disease, but the relationship between PIGF level and adverse outcomes in patients with CKD is unclear. We conducted a prospective cohort study of 1351 consecutive participants with CKD enrolled in the Novel Assessment of Risk management for Atherosclerotic diseases in CKD (NARA-CKD) study between April 1, 2004, and December 31, 2011. During a median follow-up of 3 years, 199 participants died and 383 had cardiovascular events, defined as atherosclerotic disease or heart failure requiring hospitalization. In adjusted analyses, mortality and cardiovascular risk increased in each successive quartile of serum PIGF level; hazard ratios (HRs) (95% confidence intervals [95% asp for mortality and cardiovascular risk, respectively, were 1.59 (0.83 to 3.16) and 1.55 (0.92 to 2.66) for the second quartile, 2.97 (1.67 to 5.59) and 3.39 (2.20 to 5.41) for the third quartile, and 3.87 (2.24 to 7.08) and 8.42 (5.54 to 13.3) for the fourth quartile. The composite end point of mortality and cardiovascular events occurred during the study period in 76.4% of patients in both the highest PIGF quartile (19.6 pg/ml) and the lowest eGFR tertile (