Plasma Indoxyl sulfate and estimated Glomerular filtration rate - Association with long-term clinical outcome in patients with coronary artery disease-

Daiji Yoshikawa, Hideki Ishii, Susumu Suzuki, Kyosuke Takeshita, Soichiro Kumagai, Mutsuharu Hayashi, Toshimitsu Niwa, Hideo Izawa, Toyoaki Murohara

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Abstract

Background: Indoxyl sulfate (IS), a uremic toxin, has cardiovascular as well as uremic toxicity. We evaluated the prognostic value of blood IS level for long-term outcome.

Methods and Results: This study followed 311 patients with coronary artery disease. Plasma IS level and estimated glomerular filtration rate (eGFR) were determined. The endpoint was a major adverse cardiac event (MACE). Median follow-up was 759 days. IS was significantly higher in patients with MACE than in those without (P<0.001). Patients were divided according to quartiles (Q) of plasma IS level (Q1, Q2, Q3, and Q4). On Kaplan-Meier analysis a significantly lower MACE-free rate was obtained for Q4 compared with the other quartiles (P<0.001). In patients with eGFR ≥90, 89-60, 59-30, 29-15, and <15 ml・min-1・1.73 m-2, the percentage of patients in Q4 was 0%, 13%, 29%, 100%, and 100%, respectively. In patients with eGFR 89-60 ml・min-1・1.73 m-2, there was no significant difference in MACE-free rate between Q4 and the other quartiles; in patients with eGFR 59-30 ml ・ min-1・1.73 m-2, a significantly lower MACE-free rate was obtained for Q4 compared with the other quartiles (P=0.832 and P=0.015, respectively).

Conclusions: Plasma IS level is a significant predictor of MACE, especially in patients with eGFR 59-30 ml ・ min-11.73 m-2.

Original languageEnglish
Pages (from-to)2477-2482
Number of pages6
JournalCirculation Journal
Volume78
Issue number10
DOIs
Publication statusPublished - 01-01-2014

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Indican
Glomerular Filtration Rate
Coronary Artery Disease
Kaplan-Meier Estimate

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Yoshikawa, Daiji ; Ishii, Hideki ; Suzuki, Susumu ; Takeshita, Kyosuke ; Kumagai, Soichiro ; Hayashi, Mutsuharu ; Niwa, Toshimitsu ; Izawa, Hideo ; Murohara, Toyoaki. / Plasma Indoxyl sulfate and estimated Glomerular filtration rate - Association with long-term clinical outcome in patients with coronary artery disease-. In: Circulation Journal. 2014 ; Vol. 78, No. 10. pp. 2477-2482.
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abstract = "Background: Indoxyl sulfate (IS), a uremic toxin, has cardiovascular as well as uremic toxicity. We evaluated the prognostic value of blood IS level for long-term outcome.Methods and Results: This study followed 311 patients with coronary artery disease. Plasma IS level and estimated glomerular filtration rate (eGFR) were determined. The endpoint was a major adverse cardiac event (MACE). Median follow-up was 759 days. IS was significantly higher in patients with MACE than in those without (P<0.001). Patients were divided according to quartiles (Q) of plasma IS level (Q1, Q2, Q3, and Q4). On Kaplan-Meier analysis a significantly lower MACE-free rate was obtained for Q4 compared with the other quartiles (P<0.001). In patients with eGFR ≥90, 89-60, 59-30, 29-15, and <15 ml・min-1・1.73 m-2, the percentage of patients in Q4 was 0{\%}, 13{\%}, 29{\%}, 100{\%}, and 100{\%}, respectively. In patients with eGFR 89-60 ml・min-1・1.73 m-2, there was no significant difference in MACE-free rate between Q4 and the other quartiles; in patients with eGFR 59-30 ml ・ min-1・1.73 m-2, a significantly lower MACE-free rate was obtained for Q4 compared with the other quartiles (P=0.832 and P=0.015, respectively).Conclusions: Plasma IS level is a significant predictor of MACE, especially in patients with eGFR 59-30 ml ・ min-11.73 m-2.",
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Plasma Indoxyl sulfate and estimated Glomerular filtration rate - Association with long-term clinical outcome in patients with coronary artery disease-. / Yoshikawa, Daiji; Ishii, Hideki; Suzuki, Susumu; Takeshita, Kyosuke; Kumagai, Soichiro; Hayashi, Mutsuharu; Niwa, Toshimitsu; Izawa, Hideo; Murohara, Toyoaki.

In: Circulation Journal, Vol. 78, No. 10, 01.01.2014, p. 2477-2482.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Plasma Indoxyl sulfate and estimated Glomerular filtration rate - Association with long-term clinical outcome in patients with coronary artery disease-

AU - Yoshikawa, Daiji

AU - Ishii, Hideki

AU - Suzuki, Susumu

AU - Takeshita, Kyosuke

AU - Kumagai, Soichiro

AU - Hayashi, Mutsuharu

AU - Niwa, Toshimitsu

AU - Izawa, Hideo

AU - Murohara, Toyoaki

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: Indoxyl sulfate (IS), a uremic toxin, has cardiovascular as well as uremic toxicity. We evaluated the prognostic value of blood IS level for long-term outcome.Methods and Results: This study followed 311 patients with coronary artery disease. Plasma IS level and estimated glomerular filtration rate (eGFR) were determined. The endpoint was a major adverse cardiac event (MACE). Median follow-up was 759 days. IS was significantly higher in patients with MACE than in those without (P<0.001). Patients were divided according to quartiles (Q) of plasma IS level (Q1, Q2, Q3, and Q4). On Kaplan-Meier analysis a significantly lower MACE-free rate was obtained for Q4 compared with the other quartiles (P<0.001). In patients with eGFR ≥90, 89-60, 59-30, 29-15, and <15 ml・min-1・1.73 m-2, the percentage of patients in Q4 was 0%, 13%, 29%, 100%, and 100%, respectively. In patients with eGFR 89-60 ml・min-1・1.73 m-2, there was no significant difference in MACE-free rate between Q4 and the other quartiles; in patients with eGFR 59-30 ml ・ min-1・1.73 m-2, a significantly lower MACE-free rate was obtained for Q4 compared with the other quartiles (P=0.832 and P=0.015, respectively).Conclusions: Plasma IS level is a significant predictor of MACE, especially in patients with eGFR 59-30 ml ・ min-11.73 m-2.

AB - Background: Indoxyl sulfate (IS), a uremic toxin, has cardiovascular as well as uremic toxicity. We evaluated the prognostic value of blood IS level for long-term outcome.Methods and Results: This study followed 311 patients with coronary artery disease. Plasma IS level and estimated glomerular filtration rate (eGFR) were determined. The endpoint was a major adverse cardiac event (MACE). Median follow-up was 759 days. IS was significantly higher in patients with MACE than in those without (P<0.001). Patients were divided according to quartiles (Q) of plasma IS level (Q1, Q2, Q3, and Q4). On Kaplan-Meier analysis a significantly lower MACE-free rate was obtained for Q4 compared with the other quartiles (P<0.001). In patients with eGFR ≥90, 89-60, 59-30, 29-15, and <15 ml・min-1・1.73 m-2, the percentage of patients in Q4 was 0%, 13%, 29%, 100%, and 100%, respectively. In patients with eGFR 89-60 ml・min-1・1.73 m-2, there was no significant difference in MACE-free rate between Q4 and the other quartiles; in patients with eGFR 59-30 ml ・ min-1・1.73 m-2, a significantly lower MACE-free rate was obtained for Q4 compared with the other quartiles (P=0.832 and P=0.015, respectively).Conclusions: Plasma IS level is a significant predictor of MACE, especially in patients with eGFR 59-30 ml ・ min-11.73 m-2.

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