title: Neopterin is associated with cardiovascular events and all-cause mortality in renal transplant patients.
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.
authors.affiliation: Department of Organ Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway.
authors.forename: Hege
authors.initials: H
authors.lastname: Pihlstrøm
authors.forename: Geir
authors.initials: G
authors.lastname: Mjøen
authors.forename: Winfried
authors.initials: W
authors.lastname: März
authors.forename: Dag
authors.initials: D
authors.lastname: Olav Dahle
authors.forename: Sadollah
authors.initials: S
authors.lastname: Abedini
authors.forename: Ingar
authors.initials: I
authors.lastname: Holme
authors.forename: Bengt
authors.initials: B
authors.lastname: Fellström
authors.forename: Alan
authors.initials: A
authors.lastname: Jardine
authors.forename: Stefan
authors.initials: S
authors.lastname: Pilz
authors.forename: Hallvard
authors.initials: H
authors.lastname: Holdaaas
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D003404:Creatinine / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000097:blood / Q000209:etiology / Q000401:mortality*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D019798:Neopterin; D003404:Creatinine
keywords: inflammatory marker; kidney transplantation; long-term; neopterin; outcomes