TY - JOUR
T1 - Serum calcification propensity and the risk of cardiovascular and all-cause mortality in the general population: The PREVEND study
AU - Eelderink, Coby
AU - te Velde-Keyzer, Charlotte A.
AU - Frenay, Anne-Roos S.
AU - Vermeulen, Emma A.
AU - Bachtler, Matthias
AU - Aghagolzadeh, Parisa
AU - van Dijk, Peter R.
AU - Gansevoort, Ronald T.
AU - Vervloet, Marc G.
AU - Hillebrands, Jan-Luuk
AU - Bakker, Stephan J. L.
AU - van Goor, Harry
AU - Pasch, Andreas
AU - de Borst, Martin H.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Objective: Vascular calcification contributes to the cause of cardiovascular disease. The calciprotein particle maturation time (T50) in serum, a measure of calcification propensity, has been linked with adverse outcomes in patients with chronic kidney disease, but its role in the general population is unclear. We investigated whether serum T50is associated with cardiovascular mortality in a large general population-based cohort. Approach and Results: The relationship between serum T50and cardiovascular mortality was studied in 6231 participants of the PREVEND (Prevention of Renal and Vascular End-Stage Disease) cohort. All-cause mortality was the secondary outcome. Mean (±SD) age was 53±12 years, 50% were male, and mean serum T50was 329±58 minutes. A shorter serum T50is indicative of a higher calcification propensity. Serum T50was inversely associated with circulating phosphate, age, estimated glomerular filtration rate, and alcohol consumption, whereas plasma magnesium was positively associated with serum T50(P<0.001, total multivariable model R2=0.281). During median (interquartile range) follow-up for 8.3 (7.8-8.9) years, 364 patients died (5.8%), of whom 95 (26.1%) died from a cardiovascular cause. In multivariable Cox proportional hazard models, each 60 minutes decrease in serum T50was independently associated with a higher risk of cardiovascular mortality (fully adjusted hazard ratio [95% CI], 1.22 [1.04-1.36], P=0.021). This association was modified by diabetes mellitus; stratified analysis indicated a more pronounced association in individuals with diabetes mellitus. Conclusions: Serum T50is independently associated with an increased risk of cardiovascular mortality in the general population and thus may be an early and potentially modifiable risk marker for cardiovascular mortality.
AB - Objective: Vascular calcification contributes to the cause of cardiovascular disease. The calciprotein particle maturation time (T50) in serum, a measure of calcification propensity, has been linked with adverse outcomes in patients with chronic kidney disease, but its role in the general population is unclear. We investigated whether serum T50is associated with cardiovascular mortality in a large general population-based cohort. Approach and Results: The relationship between serum T50and cardiovascular mortality was studied in 6231 participants of the PREVEND (Prevention of Renal and Vascular End-Stage Disease) cohort. All-cause mortality was the secondary outcome. Mean (±SD) age was 53±12 years, 50% were male, and mean serum T50was 329±58 minutes. A shorter serum T50is indicative of a higher calcification propensity. Serum T50was inversely associated with circulating phosphate, age, estimated glomerular filtration rate, and alcohol consumption, whereas plasma magnesium was positively associated with serum T50(P<0.001, total multivariable model R2=0.281). During median (interquartile range) follow-up for 8.3 (7.8-8.9) years, 364 patients died (5.8%), of whom 95 (26.1%) died from a cardiovascular cause. In multivariable Cox proportional hazard models, each 60 minutes decrease in serum T50was independently associated with a higher risk of cardiovascular mortality (fully adjusted hazard ratio [95% CI], 1.22 [1.04-1.36], P=0.021). This association was modified by diabetes mellitus; stratified analysis indicated a more pronounced association in individuals with diabetes mellitus. Conclusions: Serum T50is independently associated with an increased risk of cardiovascular mortality in the general population and thus may be an early and potentially modifiable risk marker for cardiovascular mortality.
KW - association
KW - calcification propensity (T )
KW - calciprotein particles
KW - cardiovascular diseases
KW - diabetes mellitus
KW - mortality
KW - population
UR - http://www.scopus.com/inward/record.url?scp=85088609394&partnerID=8YFLogxK
U2 - https://doi.org/10.1161/ATVBAHA.120.314187
DO - https://doi.org/10.1161/ATVBAHA.120.314187
M3 - Article
C2 - 32493170
SN - 1079-5642
VL - 40
SP - 1942
EP - 1951
JO - Arteriosclerosis, Thrombosis, and Vascular Biology
JF - Arteriosclerosis, Thrombosis, and Vascular Biology
IS - 8
ER -