Why the study?
Following renal transplantation, recipients remain at increased risk for cardiovascular events, but the relationship between pre-transplant Beta Trace Protein and post-transplant MACE was unknown.
Does pre-transplant serum Beta Trace Protein concentration predict post-transplant major adverse cardiac events in patients with end-stage renal disease receiving a kidney transplant?
Does pre-transplant serum Beta Trace Protein concentration predict post-transplant major adverse cardiac events in patients with end-stage renal disease receiving a kidney transplant?
Elevated pre-transplant serum Beta Trace Protein (>12.7 mg/l) independently predicts an increased risk of major adverse cardiac events following kidney transplantation.
Pre-transplant BTP may identify higher post-transplant MACE risk; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND: Beta Trace Protein (BTP) is a biomarker for residual kidney function which has been linked to cardiovascular and all-cause mortality in haemodialysis patients. Following renal transplantation, recipients remain at increased risk for cardiovascular events compared with the general population. We aimed to determine the relationship of pre-transplant BTP to major adverse cardiac events (MACE) in patients following kidney transplantation. METHODS: We included 384 patients with end-stage renal disease who received a kidney transplant. MACE was defined as myocardial infarction (ST-segment elevation or non-ST-segment elevation, stroke or transient ischemic attack), coronary artery disease requiring intervention or bypass or death for cardiovascular reason. The association between pre-transplant serum BTP concentration and post-transplant MACE was evaluated by Kaplan-Meier and Cox regression analyses. RESULTS: Post-transplant MACE occurred in 70/384 patients. Pre-transplant BTP was significantly higher in patients with post-transplant MACE (14.36 ± 5.73 mg/l vs. 11.26 ± 5.11 mg/l; p < .01). Next to smoking (HR 1.81), age > 56.38 years (HR 1.97) and pre-existing coronary heart disease (HR 8.23), BTP above the cut off value of 12.7 mg/l was confirmed as independent risk factor for MACE (HR 2.02, all p < .05). MACE-free survival inversely correlated with pre-transplant BTP levels. CONCLUSIONS: Pre-transplant serum BTP concentration may identify renal transplant recipients with higher risk of post-transplant MACE.
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Schwab et al. (2022) studied this question.
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