Photo Credit: Ekaterina Chizhevskaya
The following is a summary of “Proteomic Assessment of the Risk of Secondary Cardiovascular Events among Individuals with CKD,” published in the September 2024 issue of Nephrology by Deo et al.
Most cardiovascular risk models target incident events, leaving a gap in predicting secondary events in patients with chronic kidney disease (CKD) with a history of heart disease, stroke, or heart failure.
Researchers conducted a retrospective study to create a proteomics-based risk score for cardiovascular events in patients with CKD with a history of cardiovascular disease.
They measured 4,638 plasma proteins in 1,067 participants from the Chronic Renal Insufficiency Cohort (CRIC) and 536 from the Atherosclerosis Risk in Communities Cohort (ARIC), all with baseline non-dialysis-dependent CKD and cardiovascular conditions. They derived a proteomic risk model for secondary cardiovascular events using elastic net regression in CRIC, validated it in ARIC, and characterized the biological mechanisms of secondary events through proteomic pathway analysis.
The results showed that a 16-protein risk model surpassed the Framingham risk score for secondary cardiovascular events, including a modified score with estimated glomerular filtration rate (eGFR). In the CRIC study, the annualized area under the receiver operating characteristic (AUC) for the protein model ranged from 0.77 to 0.80, compared to 0.57 to 0.72 for clinical models. These findings were validated in the ARIC cohort, with pathway analysis identifying proteins linked to cardiac remodeling, fibrosis, vascular disease, and thrombosis.
Investigators concluded that the proteomic risk model for secondary cardiovascular events surpassed traditional clinical models based on risk factors and eGFR.
Source: journals.lww.com/jasn/abstract/9900/proteomic_assessment_of_the_risk_of_secondary.427.aspx
