β-2 microglobulin and the risk of cardiovascular mortality in the creatinine-blind range
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Prevention
E1334JACC March 12, 2013Volume 61, Issue 10
β-2 microgloBulin and The risk of cardiovascular morTaliTy in The creaTinine-Blind range
Poster ContributionsPoster Sessions, Expo NorthSaturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Prevention: Risk Assessment and PreventionAbstract Category: 24. Prevention: ClinicalPresentation Number: 1100-6
Authors: Kaustubh C. Dabhadkar, Abhishek Deshmukh, Pankaj Manocha, Tushar Tuliani, Jawahar Mehta, Emory University, Atlanta, GA, USA, University of Arkansas Medical Sciences, Little Rock, AR, USA
Background: β-2 microglobulin (B2M) is emerging as a predictor of mortality in patients with impaired renal function. We studied association between B2M and cardiovascular disease (CVD) and ischemic heart disease (IHD) mortality in participants with creatinine based glomerular filtration rate (GFR) > 60 ml/min/1.73 m2 in National Health and Nutrition Examination Survey III.
methods: Participants > 30 y with GFR > 60 ml/min/1.73 m2 had B2M and CVD risk factors measured. CVD and IHD mortality through 2006 were obtained via linkage with the National Death Index. Participants were divided in quartiles based on B2M. Cox proportional hazards model was used to estimate hazards ratio (HR) and 95% confidence interval (CI) for mortality.
results: 4894 participants (mean age 59.5 ± 15.6 y, 51.8 % females, and 28.1 % ethnic minorities) with mean B2M 2.08 ± 0.61 were included. Over median follow-up of 13.7 y, there were 558 CVD and 407 IHD deaths. In multivariate analysis, compared with first quartile, the HRs (95 % CI) for CVD mortality were: second quartile 1.07 (0.75-1.51); third quartile 1.52 (1.07-2.15); and fourth quartile 1.89 (1.32 - 2.7). Similarly, HR (95 % CI) for IHD mortality: second quartile 1 (0.67-1.49); third quartile 1.52 (1.02-2.26); and fourth quartile 1.62 (1.08 - 1.45). Increasing quartiles of B2M was strong marker of risk for future CVD and IHD mortality.
conclusion: In a nationally representative sample of US adults in creatinine blind GFR range, higher B2M conveyed greater hazard for IHD and CVD mortality.