title: Soluble P-selectin levels are associated with cardiovascular mortality and sudden cardiac death in male dialysis patients.
abstract: OBJECTIVE
  P-selectin is released by activated platelets and endothelium contributing to inflammation and thrombosis. We evaluated the association between soluble P-selectin and atherosclerotic cardiovascular disease (ASCVD) in dialysis patients.
  
  
  METHODS
  We measured soluble P-selectin in serum from 824 incident dialysis patients. Using Cox proportional hazards models, we modeled the association of P-selectin levels with ASCVD events, cardiovascular mortality and sudden cardiac death.
  
  
  RESULTS
  After adjustment for demographics, comorbidity and traditional cardiovascular risk factors, higher P-selectin levels were associated with increased risk of ASCVD and cardiovascular mortality among males (p = 0.02 and p = 0.01, respectively), but not females (p = 0.52 and p = 0.31, respectively; p interaction = 0.003), over a median of 38.2 months. Higher P-selectin was associated with a greater risk of sudden cardiac death among males (p = 0.05). The associations between increasing P-selectin and cardiovascular mortality as well as sudden cardiac death in males persisted after adjustment for C-reactive protein, interleukin-6, serum albumin and platelet count (p = 0.01 and p = 0.03, respectively). The risk for sudden cardiac death was more than 3 times greater for males in the highest tertile of soluble P-selectin compared with the lowest tertile after adjustment (HR: 3.19; 95% CI: 1.18 - 8.62; p = 0.02).
  
  
  CONCLUSIONS
  P-selectin is associated with ASCVD, cardiovascular mortality and sudden cardiac death among male dialysis patients.
authors.affiliation: Department of Medicine, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. jsciall1@jhmi.edu
authors.forename: Julia J
authors.initials: JJ
authors.lastname: Scialla
authors.forename: Laura C
authors.initials: LC
authors.lastname: Plantinga
authors.forename: W H Linda
authors.initials: WH
authors.lastname: Kao
authors.forename: Bernard
authors.initials: B
authors.lastname: Jaar
authors.forename: Neil R
authors.initials: NR
authors.lastname: Powe
authors.forename: Rulan S
authors.initials: RS
authors.lastname: Parekh
mesh_terms: D001161:Arteriosclerosis / Q000097:blood / Q000401:mortality; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000401:mortality; D008297:Male; D019007:P-Selectin / Q000097:blood*; D006435:Renal Dialysis
chemical_list: D019007:P-Selectin