A study found that patients with altered levels of oteoprotegerin, osteopontin and an inflammatory cytokine have nine times more risk of suffering a cardiovascular disease. The researchers suggest that these biomarkers should be taken into account in the algorithms for predicting cardiovascular risk, especially in patients with chronic kidney disease.
A team of researchers at the Center for Biomedical Research in Network for Cardiovascular Diseases (CIBER-CV), led by Luis Miguel Blanco-Colio at the Jiménez Díaz Foundation Health Research Institute in Madrid, found that the combination of altered levels of two vascular calcification biomarkers –osteoprotegerin and osteopontin– and the inflammatory cytokine TWEAK, increases the prediction of cardiovascular events in patients with chronic kidney disease.
The research had the participation of the the head of the CIBER for Diabetes and Associated Metabolic Diseases (CIBER-DEM) Jesus Egido, the Institut de Recerca Biomèdica (IRB) of Lleida and the Renal Research Network RedinRen.
The researchers studied the circulating levels of these three proteins in more than 1,000 patients included in the NEFRONA project (National Atherosclerosis Observatory in Nephrology), an observational, prospective and multicenter study of cardiovascular morbidity and mortality in patients with chronic kidney disease throughout the Spanish territory.
The NEFRONA study was designed to analyze the prevalence of latent atherosclerosis (without symptoms) in patients in different stages of chronic kidney disease, its association with different circulating biomarkers, as well as its association with the presence of cardiovascular events after four years of follow-up.
The CIBERCV researchers now show that the combination of altered levels of the three proteins increases the risk of suffering a cardiovascular disease. “For the first time it has been shown that the subjects who had these three altered circulating biomarkers had nine times more risk of suffering a cardiovascular accident than those in whom these biomarkers were at normal levels,” says the head of the CIBERCV group Luis Miguel Blanco -Colio.
Improve risk prediction
The inclusion of this set of biomarkers in cardiovascular risk models with classic risk factors such as lipid levels, blood pressure, presence of diabetes, smoking, and presence of vascular calcification improved risk prediction in this population.
The presence of chronic kidney disease is associated with a high incidence of cardiovascular events. In fact, mortality from cardiovascular causes increases progressively as the glomerular filtration rate decreases. Although traditional risk factors such as high cholesterol levels, hypertension, diabetes and smoking may explain the cardiovascular risk associated with the presence of chronic kidney disease, other factors should contribute to this increased risk observed in patients with this pathology.
Therefore, “additional diagnostic tools are needed that can help us better predict cardiovascular risk in this type of patient and allow us to improve the pharmacological intervention on them,” says researcher Luis Miguel Blanco-Colio.
The results of this study, in short, suggest that these biomarkers should be taken into account in the prediction algorithms of cardiovascular risk, especially in patients with chronic kidney disease.