Abstract
S5-20 Citation: Atherosclerosis Supplement 2009, Vol. 10, Issue 2 ENDOTHELIAL MARKERS AS PREDICTORS OF 5-YEAR CARDIOVASCULAR MORTALITY IN PATIENTS ON CHRONIC HAEMODIALYSIS D Kirmizis, M Pangalou, G Niavis, A Tsiandoulas, M Protopappa, K Barboutis Alpha-Nephrodynamic Dialysis Unit, Serres; Laboratory of Haematology, Serres General Hospital, Serres; Department of Nephrology, Serres General Hospital, Serres The objective of this follow-up study was to determine the significance of established endothelial markers, ie plasma fibrinogen (Fb), von Willebrand factor (vWF) and D-dimer (Dd), as predictors of 5-year cardiovascular (CV) mortality in pts on chronic hemodialysis (HD). Methods: In 75 HD pts (43 males, mean age 63, range 40-77 yrs) we studied the 5-yr CV mortality in relation to Fb, vWF and Dd. Fb was measured by Clauss method and vWf and Dd by latex-enhanced immunoassay. Serum CRP was measured by nephelometry. Cut-off values with the optimal sensitivity and specificity for CV morbidity were calculated with the use of AUC, LR and ROC curves for each variable. Survival analysis was made by the Kaplan-Meier (K-M) method, with the use of Breslow test and Cox regression analysis. Results: Overall 30 of the 68 pts who completed the study (44%) died from CV events. Pts with Dd 335 mg/L had a shorter survival compared to patients with Dd <335 mg/L (median survival time: 28.6 vs 46.8 mts respectively, P<0.001). Plasma Fb 333mg/L and vWF 201%, respectively were not found to be of any predictive CV significance. In Cox regression analysis logDd levels were a strong predictor of CV death, as much as serum logCRP and history of CVD. Age, sex, HD duration, arterial hypertension and plasma Fb and vWF levels failed to show any predictive CV significance. Conclusion: In HD patients, Dd predict the 5-yr CV survival and might represent a marker of atheromatous process. Funding: Any funding sources of commercial nature for the work being presented are disclosed.
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