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Abstract: TH-PO822

Role of Angiopoietins in Cardiovascular Disease (CVD) Outcomes of Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Brown, Liam, Yale School of Medicine, New Haven, Connecticut, United States
  • Gendy, Natalie, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
  • Staunton, Mary Kate, Yale School of Medicine, New Haven, Connecticut, United States
  • Garg, Kanika K., Yale School of Medicine, New Haven, Connecticut, United States
  • Yamamoto, Yu, Yale School of Medicine, New Haven, Connecticut, United States
  • Obeid, Wassim, Johns Hopkins University, Baltimore, Maryland, United States
  • Bostom, Andrew, Brown University, Providence, Rhode Island, United States
  • Mansour, Sherry, Yale School of Medicine, New Haven, Connecticut, United States
Background

Kidney transplant recipients have 30 times the risk of dying from cardiovascular disease (CVD). We tested the role of 2 vascular biomarkers, angiopoietin-1 and angiopoietin-2 (angpt-1, -2), in the development of CVD in deceased donor kidney transplant recipients.

Methods

This is an ancillary analysis of the FAVORIT study, evaluating the associations between baseline levels of angpt-1 and angpt-2 in the development of CVD and the secondary outcomes of graft failure (GF) and death in 2000 recipients. We used a Cox regression analysis to test the associations between biomarker quartiles and outcomes.

Results

Median age of participants was 52 IQR [45, 59] years with 37% women and 73% identifying as white. Median time from transplantation to biomarker measurement was 3.99 IQR [1.58, 7.93] years. Median time to the development of CVD was 3.7 IQR [2.89-5.25] years. Angpt-1 was not significantly associated with outcomes. Higher levels of angpt-2 (quartile 4) as compared to quartile 1 had about 2 times the risk of CVD, GF and death [aHR 1.85 (1.25 - 2.73), P<.01; 2.24 (1.36 - 3.70), P<.01; 2.30 (1.48 - 3.58), P<.01, respectively, (Figure 1)].

Conclusion

Angpt-2 may identify high-risk kidney transplant recipients for the development of CVD. This may aid in tailoring follow-up after transplantation to reduce the risk of CVD.

The red line represents the probability of not developing CVD in patients with quartile 1 of angiopoietin-2 concentrations. Quartiles 2,3, and 4 are represented by the green, blue, and purple lines respectively. We adjusted for demographics (age, sex, race, and ethnicity); CVD related factors (hypertension, diabetes mellitus, body mass index, history of CVD, baseline estimated glomerular filtration rate); transplant-related variables (pancreas transplant, and graft vintage at randomization); medications (lipid lowering drugs, cyclosporine, tacrolimus, sirolimus, mycophenolate, azathioprine, and prednisone); and urine albumin-to-creatinine ratio and randomization status.

Funding

  • NIDDK Support