Neopterin is associated with cardiovascular events and all-cause mortality in renal transplant patients

Pihlstrøm, H., Mjøen, G., März, W., Olav Dahle, D., Abedini, S., Holme, I., Fellström, B., Jardine, A. , Pilz, S. and Holdaas, H. (2014) Neopterin is associated with cardiovascular events and all-cause mortality in renal transplant patients. Clinical Transplantation, 28(1), pp. 111-119. (doi: 10.1111/ctr.12285) (PMID:24372612) (PMCID:PMC4204514)

Abstract

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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Jardine, Professor Alan
• Authors: Pihlstrøm, H., Mjøen, G., März, W., Olav Dahle, D., Abedini, S., Holme, I., Fellström, B., Jardine, A., Pilz, S., and Holdaas, H.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Clinical Transplantation
• Publisher: John Wiley & Sons Ltd
• ISSN: 0902-0063
• ISSN (Online): 1399-0012
• Copyright Holders: Copyright © 2013 The Authors
• First Published: First published in Clinical Transplantation 28(1):111-119
• Publisher Policy: Reproduced under a Creative Commons License