title: Placental Growth Factor as a Predictor of Cardiovascular Events in Patients with CKD from the NARA-CKD Study.
abstract: Placental growth factor (PlGF) contributes to atherogenesis through vascular inflammation and plaque destabilization. High levels of PlGF may be associated with mortality and cardiovascular disease, but the relationship between PlGF level and adverse outcomes in patients with CKD is unclear. We conducted a prospective cohort study of 1351 consecutive participants with CKD enrolled in the Novel Assessment of Risk management for Atherosclerotic diseases in CKD (NARA-CKD) study between April 1, 2004, and December 31, 2011. During a median follow-up of 3 years, 199 participants died and 383 had cardiovascular events, defined as atherosclerotic disease or heart failure requiring hospitalization. In adjusted analyses, mortality and cardiovascular risk increased in each successive quartile of serum PlGF level; hazard ratios (HRs) (95% confidence intervals [95% CIs]) for mortality and cardiovascular risk, respectively, were 1.59 (0.83 to 3.16) and 1.55 (0.92 to 2.66) for the second quartile, 2.97 (1.67 to 5.59) and 3.39 (2.20 to 5.41) for the third quartile, and 3.87 (2.24 to 7.08) and 8.42 (5.54 to 13.3) for the fourth quartile. The composite end point of mortality and cardiovascular events occurred during the study period in 76.4% of patients in both the highest PlGF quartile (≥19.6 pg/ml) and the lowest eGFR tertile (<30 ml/min per 1.73 m(2)). The association between PlGF and mortality or cardiovascular events was not attenuated when participants were stratified by age, sex, traditional risk factors, and eGFR. These data suggest elevated PlGF is an independent risk factor for all-cause mortality and cardiovascular events in patients with CKD.
authors: First Department of Internal Medicine and.
authors: Masaru
authors: M
authors: Matsui
authors: First Department of Internal Medicine and.
authors: Shiro
authors: S
authors: Uemura
authors: First Department of Internal Medicine and.
authors: Yukiji
authors: Y
authors: Takeda
authors: First Department of Internal Medicine and Department of Medicine, Ohyodo Town Hospital, Nara, Japan;
authors: Ken-Ichi
authors: K
authors: Samejima
authors: First Department of Internal Medicine and.
authors: Takaki
authors: T
authors: Matsumoto
authors: First Department of Internal Medicine and.
authors: Ayako
authors: A
authors: Hasegawa
authors: Department of Medicine, Ohyodo Town Hospital, Nara, Japan;
authors: Hideo
authors: H
authors: Tsushima
authors: Department of Medicine, Saisei-kai Nara City Hospital, Nara, Japan;
authors: Ei
authors: E
authors: Hoshino
authors: First Department of Internal Medicine and.
authors: Tomoya
authors: T
authors: Ueda
authors: First Department of Internal Medicine and.
authors: Katsuhiko
authors: K
authors: Morimoto
authors: First Department of Internal Medicine and.
authors: Keisuke
authors: K
authors: Okamoto
authors: First Department of Internal Medicine and.
authors: Sadanori
authors: S
authors: Okada
authors: First Department of Internal Medicine and.
authors: Kenji
authors: K
authors: Onoue
authors: First Department of Internal Medicine and.
authors: Satoshi
authors: S
authors: Okayama
authors: First Department of Internal Medicine and.
authors: Hiroyuki
authors: H
authors: Kawata
authors: First Department of Internal Medicine and.
authors: Rika
authors: R
authors: Kawakami
authors: Department of Cardiology, Nara City General Hospital, Nara, Japan;
authors: Naoki
authors: N
authors: Maruyama
authors: First Department of Internal Medicine and.
authors: Yasuhiro
authors: Y
authors: Akai
authors: Department of Nephrology, Fukui University, Fukui, Japan; and.
authors: Masayuki
authors: M
authors: Iwano
authors: Department of Medicine, Uda City General Hospital, Nara, Japan.
authors: Hideo
authors: H
authors: Shiiki
authors: First Department of Internal Medicine and Department of Regulatory Medicine for Blood Pressure, Nara Medical University, Nara, Japan; saitonaramed@gmail.com.
authors: Yoshihiko
authors: Y
authors: Saito
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000150:complications; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood / Q000150:complications; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D000072483:Placenta Growth Factor; D011257:Pregnancy Proteins / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications; D012307:Risk Factors; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: C000608036:PGF protein, human; D011257:Pregnancy Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D020097:Natriuretic Peptide, Brain; D000072483:Placenta Growth Factor
keywords: VEGF; cardiovascular disease; cardiovascular events