Association of α-Klotho Levels with Clinical and Laboratory Parameters and Cardiorenal Outcomes in Patients with ACS Following PCI

Background: Whether plasma α-Klotho carries prognostic value in patients with acute coronary syndrome (ACS) who undergo percutaneous coronary intervention (PCI) is still unclear. Objectives: We set out to examine the links between plasma α-Klotho levels, routine clinical and laboratory findings, the occurrence of acute kidney injury (AKI), and cardiovascular mortality after PCI. Methods: Eighty-six patients with ACS treated by PCI were enrolled in this prospective study. Plasma α-Klotho was measured within 48 h of the procedure. Relationships were assessed by correlation analysis and logistic regression; cardiovascular mortality was tracked for 12 months. Results: Acute kidney injury developed in 30 patients (34.9%), and nine cardiovascular deaths (10.5%) occurred during the year of follow-up. α-Klotho showed positive correlations with platelet count, triglycerides and total protein, and inverse correlations with FIB-4, aspartate aminotransferase, creatinine, GRACE score, contrast volume and international normalized ratio. No significant link was found between α-Klotho and AKI (p = 0.882). Erythrocyte sedimentation rate (OR = 1.090; p < 0.001) and contrast volume (OR = 1.014; p = 0.007) remained independently associated with AKI. In univariable analysis higher α-Klotho levels were linked to lower cardiovascular mortality (OR = 0.648; p = 0.009). Conclusions: Higher plasma α-Klotho concentrations were associated with reduced odds of cardiovascular death in the univariable model. No association with AKI was detected. The mortality results should be regarded as exploratory and do not demonstrate an independent prognostic role.