Syndecan-4 Is an Independent Predictor of All-Cause as Well as Cardiovascular Mortality in Hemodialysis Patients.
BACKGROUND
Left ventricular hypertrophy is associated withincreased mortality in hemodialysis (HD) patients.Syndecan-4 plays a role in many processes that are involved in the heart fibrosis and hypertrophy.We designed this study to prospectively determine whether syndecan-4 was predictive of mortality in a group of HD patients.


METHODS
In total, 191 HD patients were included. Clinical, biochemical and echocardiographic parameters were recorded. HD patients were followed-up for 23.18 ± 4.02 months.


RESULTS
Syndecan-4 levels correlated strongly with geometrical echocardiographic parameters and ejection fraction. Relations with pressure-related parameters were weak and only marginally significant. Using the receiver operating characteristics the optimal cut-off points in predicting all-cause as well as cardiovascular (CV) mortality were evaluated and patients were divided into low and high syndecan-4 groups. A Kaplan-Meier analysis showed that the cumulative incidences of all-cause as well as CV mortality were higher in high serum syndecan-4 group compared with those with low serum syndecan-4 (p<0.001 in both cases).A multivariate Cox proportional hazards regression analysis revealed syndecan-4 concentration to be an independent and significant predictor of all-cause (hazard ratio, 2.99; confidence interval, 2.34 to 3.113; p<0.001)as well as CV mortality (hazard ratio, 2.81;confidence interval, 2.28to3.02; p<0.001).


CONCLUSIONS
Serum syndecan-4 concentration reflects predominantly geometrical echocardiographic parameters. In HD patients serum syndecan-4 concentration is independently associated with all-cause as well as CV mortality.
Institute of Medical Sciences, Jan Kochanowski University in Kielce, Kielce, Poland.|Department of Family Medicine, Medical University of Lublin, Lublin, Poland.
Andrzej J
AJ
Jaroszyński
Department of Cardiology, Medical University of Lublin, Lublin, Poland.
Anna
A
Jaroszyńska
Department of Vascular Surgery, Medical University of Lublin, Lublin, Poland.
Stanisław
S
Przywara
Department of Family Medicine, Medical University of Lublin, Lublin, Poland.
Tomasz
T
Zaborowski
Department of Nephrology, Medical University of Lublin, Lublin, Poland.
Andrzej
A
Książek
Department of Anesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland.
Wojciech
W
Dąbrowski
Thromb Haemost. 2001 May;85(5):793-9
11372670
J Mol Cell Cardiol. 2012 Aug;53(2):250-8
22561100
Int J Clin Exp Pathol. 2015 Jun 01;8(6):6387-96
26261514
BMC Res Notes. 2014 Nov 19;7:815
25410619
Clin Exp Nephrol. 2015 Dec;19(6):1157-64
25724127
Clin J Am Soc Nephrol. 2009 Dec;4 Suppl 1:S79-91
19996010
Blood Purif. 2010;29(2):105-10
20093813
N Engl J Med. 1998 Sep 17;339(12):799-805
9738087
Nefrologia. 2012;32(1):94-102
22240880
Matrix Biol. 2012 Jan;31(1):3-16
22033227
Nephrol Ther. 2016 Apr;12(2):94-7
26612488
Cardiovasc Diabetol. 2011 Apr 25;10 :35
21518435
Int J Cardiol. 2013 Oct 3;168(3):2404-10
23416015
Kidney Int. 2005 Jan;67(1):217-26
15610245
Adv Chronic Kidney Dis. 2014 Nov;21(6):480-8
25443573
Mol Med. 2016 Jan 21;:null
26835698
J Cardiol. 2011 May;57(3):325-32
21397460
J Am Coll Cardiol. 2016 Mar 15;67(10 ):1173-82
26965538
Eur J Echocardiogr. 2009 Mar;10 (2):165-93
19270053
Kidney Int. 2004 Jun;65(6):2380-9
15149351
J Histochem Cytochem. 2015 Apr;63(4):280-92
25575567
J Clin Pathol. 2009 Jan;62(1):1-5
18818262
Proc Natl Acad Sci U S A. 2014 Dec 2;111(48):17308-13
25404299
Cardiovasc Res. 2011 Oct 1;92(1):123-31
21632883
Cardiorenal Med. 2015 Oct;5(4):254-66
26648942
Circ Res. 2011 May 27;108(11):1328-39
21493899
PLoS One. 2011;6(12):e28302
22164265
FEBS J. 2013 May;280(10):2228-47
23374111
Clin J Am Soc Nephrol. 2016 Feb 5;11(2):271-9
26668021
Circulation. 1977 Apr;55(4):613-8
138494
J Cell Sci. 2013 Sep 1;126(Pt 17):3799-804
23970415
J Am Soc Echocardiogr. 2015 Jan;28(1):1-39.e14
25559473
J Mol Cell Cardiol. 2013 Jan;54:73-81
23178899
Circ J. 2015;79(7):1444-5
26027446
J Mol Cell Cardiol. 2013 Mar;56:19-21
23266594
Clin J Am Soc Nephrol. 2012 Oct;7(10 ):1615-23
22822014