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Serum uromodulin predicts mortality independently from the presence of type 2 diabetes

Session Poster session 7

Speaker Christoph Saely

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Acute Coronary Syndromes: Biomarkers
  • Session type : Poster Session

Authors : A Leiherer (Feldkirch,AT), A Muendlein (Feldkirch,AT), CH Saely (Triesen,LI), J Ebner (Feldkirch,AT), EM Brandtner (Feldkirch,AT), A Schuler (Feldkirch,AT), P Schwerzler (Triesen,LI), A Mader (Triesen,LI), P Fraunberger (Feldkirch,AT), H Drexel (Philadelphia,US)

Authors:
A. Leiherer1 , A. Muendlein1 , C.H. Saely2 , J. Ebner1 , E.M. Brandtner1 , A. Schuler3 , P. Schwerzler2 , A. Mader2 , P. Fraunberger4 , H. Drexel5 , 1VIVIT Institute - Feldkirch - Austria , 2Private University of the Principality of Liechtenstein - Triesen - Liechtenstein , 3Academic Teaching Hospital, Department of Medicine and Cardiology - Feldkirch - Austria , 4Medical Central Laboratory - Feldkirch - Austria , 5Drexel University College of Medicine - Philadelphia - United States of America ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 1325

Introduction: Uromodulin is produced exclusively by the kidneys and present in urine and blood. Low serum uromodulin has recently been demonstrated to be associated with chronic kidney disease and type 2 diabetes (T2DM).

Purpose: The purpose of this study was to investigate whether serum uromodulin also is a useful predictor of mortality.

Methods: We measured uromodulin in a series of 529 patients who underwent coronary angiography for the evaluation of established or suspected stable CAD and prospectively recorded mortality during a follow-up of up to 8 years.

Results: Uromodulin significantly correlated with eGFR (r=0.242, p<0.001) and, inversely, with age (r=-0.208, p<0.001), fasting glucose (r=-0.161, p<0.001), C-reactive protein (CRP; r=-0.133, p=0.002) and proBNP (r=-0.164, p=0.002); it was significantly lower in patients with T2DM than in nondiabetic subjects (148±70 vs. 171±79; p=0.001). Prospectively, we recorded 95 deaths; mortality was significantly higher in patients with T2DM than in those who did not have diabetes (28.2 vs. 14.6%; p<0.001). Serum uromodulin proved protective for overall mortality in univariate analysis (HR=0.56 [95% CI 0.43–0.72]; p<0.001), and also after multivariate adjustment for standard risk factors including diabetes, eGFR, proBNP and presence of CAD as well (adj. HR=0.57 [95% CI 0.37–0.89]; p=0.014).

Conclusion: We conclude that serum uromodulin predicts mortality independently from kidney function and the presence of T2DM.

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