Soluble P-selectin levels are associated with cardiovascular mortality and sudden cardiac death in male dialysis patients

Julia J. Scialla, Laura C. Plantinga, W. H.Linda Kao, Bernard Jaar, Neil R. Powe, Rulan S. Parekh

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background/Aims: P-selectin is released by activated platelets and endothelium contributing to inflammation and thrombosis. We evaluated the association between soluble P-selectin and atherosclerotic cardiovascular disease (ASCVD) in dialysis patients. Methods: We measured soluble P-selectin in serum from 824 incident dialysis patients. Using Cox proportional hazards models, we modeled the association of P-selectin levels with ASCVD events, cardiovascular mortality and sudden cardiac death. Results: After adjustment for demographics, comorbidity and traditional cardiovascular risk factors, higher P-selectin levels were associated with increased risk of ASCVD and cardiovascular mortality among males (p = 0.02 and p = 0.01, respectively), but not females (p = 0.52 and p = 0.31, respectively; p interaction = 0.003), over a median of 38.2 months. Higher P-selectin was associated with a greater risk of sudden cardiac death among males (p = 0.05). The associations between increasing P-selectin and cardiovascular mortality as well as sudden cardiac death in males persisted after adjustment for C-reactive protein, interleukin-6, serum albumin and platelet count (p = 0.01 and p = 0.03, respectively). The risk for sudden cardiac death was more than 3 times greater for males in the highest tertile of soluble P-selectin compared with the lowest tertile after adjustment (HR: 3.19; 95% CI: 1.18-8.62; p = 0.02). Conclusion: P-selectin is associated with ASCVD, cardiovascular mortality and sudden cardiac death among male dialysis patients.

Original languageEnglish (US)
Pages (from-to)224-230
Number of pages7
JournalAmerican Journal of Nephrology
Volume33
Issue number3
DOIs
StatePublished - Mar 2011

Keywords

  • Cardiovascular disease
  • Dialysis
  • End-stage renal disease
  • Inflammation
  • P-selectin
  • Sudden cardiac death

ASJC Scopus subject areas

  • Nephrology

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