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Neopterin is associated with cardiovascular events and all‐cause mortality in renal transplant patients
Author(s) -
Pihlstrøm Hege,
Mjøen Geir,
März Winfried,
Olav Dahle Dag,
Abedini Sadollah,
Holme Ingar,
Fellström Bengt,
Jardine Alan,
Pilz Stefan,
Holdaas Hallvard
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12285
Subject(s) - neopterin , medicine , kidney transplantation , creatinine , cystatin c , transplantation , mace , renal function , incidence (geometry) , prospective cohort study , myocardial infarction , physics , conventional pci , optics
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.