Lipoprotein (a) Cut-Off in Chronic Kidney Disease Patients with a History of Cardiovascular Disease in Center Hospital University Souro SANOU, Burkina Faso
Patients living with chronic kidney disease (CKD) are at high risk of cardiovascular events. Our aim in this study was to assess the cut-off value for lipoprotein (a) (Lp(a)) in CKD patients with a history of cardiovascular disease (CVD). This was a cross-sectional study. Variables including age, sex, history of CVD, body mass index and CKD stage, were collected during CKD patient’s first admission in the nephrology dialysis department. Blood samples were collected for quantitative determination of Lp(a) by immunoturbidimetric method. They were divided into two groups: CKD patients without history of CVD and CKD patients with history of CVD. Fisher’s exact test was used to assess associations with a significance level of 0.05%. Area under the curve (AUC) and new cut-off value for Lp(a) were identified by drawing Receiver Operating Characteristic (ROC) curve. A total of seventy CKD patients with median age of 43 years [minimum-maximum = 15 - 78 years] were included. Patients with history of CVD were 65.71% (46/70). New Lp(a) cut-off point in CKD patients with history of CVD was 66.50 nmol/L [sensitivity, 87.00%; specificity, 58.30%; AUC = 0.727; p = 0.000]. ROC curve demonstrated good performance of Lp(a) to screen CKD patients with history of CVD. Further research is needed to determine an LPA gene polymorphism’s contribution to increasing risk for CVD at each kidney disease stage.
References
[1]
Reyes-Soffer, G., Ginsberg, H.N., Berglund, L., Duell, P.B., Heffron, S.P., Kamstrup, P.R., Loyd-Jones, D.M., Marcovina, S.M., Yeang, C., Koschinsky, M.L., American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology, Council on Cardiovascular Radiology and Intervention and Council on Peripheral Vascular Disease (2022) Lipoprotein (a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement from the American Heart Association. Arteriosclerosis, Thrombosis and Vascular Biology, 42, e48-e60. https://doi.org/10.1161/ATV.0000000000000147
[2]
Soren, J., Majhi, C. and Patel, N.K. (2021) Electrocardiography in Post Hemodialysed Chronic Kidney Disease Patients. International Journal of Advances in Medicine, 8, 653-656. https://doi.org/10.18203/2349-3933.ijam20211470
[3]
Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group (2009) KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney International Supplement, 113, S1-S130.
[4]
Ovwasa, H., Aiwuyo, H.O., Okoye, O.A., Umuerri, E.M., Obasohan, A., Unuigbe, E. and Rajora, N. (2023) Risk Assessment of Pre-Dialysis Chronic Kidney Disease (CKD) Patients for Cardiovascular Disease (CVD) in a Tertiary Hospital in Nigeria: A Case-Controlled Cross-Sectional Study. Cureus, 15, e36725. https://doi.org/10.7759/cureus.36725
[5]
Barbagelata, L., Masson, W., Corral, P., Lavalle-Cobo, A., Nogueira, J.P. and Rosa Diez, G. (2023) Relationship between Lipoprotein(a) Levels, Cardiovascular Outcomes and Death in Patients with Chronic Kidney Disease: A Systematic Review of Prospective Studies. Journal of Nephrology, 36, 1549-1559. https://doi.org/10.1007/s40620-023-01590-3
[6]
Kronenberg, F. (2021) Lipoprotein (a). In: von Eckardstein, A. and Binder, C.J., Eds., Prevention and Treatment of Atherosclerosis: Handbook of Experimental Pharmacology, Vol. 270, Springer, Cham, 201-232.
[7]
Grüneis, R., Lamina, C., Di Maio, S., Schönherr, S., Zoescher, P., Forer, L., Streiter, G., Pters, A., Gieger, C., Köttgen, A., Kronenberg, F. and Coassin, S. (2022) The Effect of LPA Thr3888Pro on Lipoprotein(a) and Coronary Artery Disease Is Modified by the LPA KIV-2 Variant 4925G > A. Atherosclerosis, 349, 151-159. https://doi.org/10.1016/j.atherosclerosis.2022.04.023
[8]
Marcovina, S.M., Koschinsky, M.L., Albers, J.J. and Skarlatos, S. (2003) Report of the National Heart, Lung, and Blood Institute Workshop on Lipoprotein (a) and Cardiovascular Disease: Recent Advances and Future Directions. Clinical Chemistry, 49, 1785-1796. https://doi.org/10.1373/clinchem.2003.023689
[9]
Levey, A.S., Coresh, J., Greene, T., Marsh, J., Stevens, L.A., Kusek, J.W., Van Lente, F. and Chronic Kidney Disease Epidemiology Collaboration (2007) Expressing the Modification of Diet in Renal Disease Study Equation for Estimating Glomerular Filtration Rate with Standardized Serum Creatinine Values. Clinical Chemistry, 53, 766-772. https://doi.org/10.1373/clinchem.2006.077180
[10]
Enkhmaa, B. and Berglund, L. (2022) Non-Genetic Influences on Lipoprotein (a) Concentrations. Atherosclerosis, 349, 53-62. https://doi.org/10.1016/j.atherosclerosis.2022.04.006
[11]
Li, Q., Chen, Y., Yu, L., Zhu, L., Wang, Z., Jiao, S., Wu, C., Tu, Y., Wu, Y., Guo, Z., Gao, Y., Zheng, J. and Sun, Y.H. (2022) The Relationship between Lipoprotein (a) and Cardiovascular Events in Acute Coronary Syndrome Patients with and without Chronic Kidney Disease. Atherosclerosis, 349, 204-210. https://doi.org/10.1016/j.atherosclerosis.2022.04.007
[12]
Jankowska, M., Lindholm, B. and Stenvinkel, P. (2023) Cardiovascular Disease and Inflammation. In: Khanna, R. and Krediet, R.T., eds., Nolph and Gokal’s Textbook of Peritoneal Dialysis, Springer, Cham, 575-596. https://doi.org/10.1007/978-3-030-62087-5_23
[13]
Xie, Y., Qi, H., Li, B., Wen, F., Zhang, F., Guo, C. and Zhang, L. (2022) Serum Lipoprotein (a) Associates with the Risk of Renal Function Damage in the CHCN-BTH Study: Cross-Sectional and Mendelian Randomization Analyses. Frontiers in Endocrinology, 13, Article 1023919. https://doi.org/10.3389/fendo.2022.1023919
[14]
Reyes-Soffer, G. (2021) The Impact of Race and Ethnicity on Lipoprotein (a) Levels and Cardiovascular Risk. Current Opinion in Lipidology, 32, 163-166. https://doi.org/10.1097/MOL.0000000000000753
[15]
Enkhmaa, B., Anuurad, E. and Berglund, L. (2016) Lipoprotein (a): Impact by Ethnicity and Environmental and Medical Conditions. Journal of Lipid Research, 57, 1111-1125. https://doi.org/10.1194/jlr.R051904
[16]
Marcovina, S.M. and Albers, J.J. (2016) Lipoprotein (a) Measurements for Clinical Application. Journal of Lipid Research, 57, 526-537. https://doi.org/10.1194/jlr.R061648
[17]
Nordestgaard, B.G., Chapman, M.J., Ray, K., Borén, J., Andreotti, F., Watts, G.F., Ginsberg, H., Amarenco, P., Catapano, A., Descamps, O.S., Fisher, E., Kovanen, P.T., Kuivenhoven, J.A., Lesnik, P., Masana, L., Reiner, Z., Taskinen, M.R., Tokgözoglu, L., Tybjærg-Hansen, A. and European Atherosclerosis Society Consensus Panel (2010) Lipoprotein(a) as a Cardiovascular Risk Factor: Current Status. European Heart Journal, 31, 2844-2853. https://doi.org/10.1093/eurheartj/ehq386
[18]
Mehta, A., Jain, V., Saeed, A., Saseen, J.J., Gulati, M., Ballantyne, C.M. and Virani, S.S. (2022) Lipoprotein (a) and Ethnicities. Atherosclerosis, 349, 42-52. https://doi.org/10.1016/j.atherosclerosis.2022.04.005
[19]
Guan, W., Cao, J., Steffen, B.T., Post, W.S., Stein, J.H., Tattersall, M.C., Kaufman, J.D., McConnell, J.P., Hoefner, D.M., Warnick, R. and Tsai, M.Y. (2015) Race Is a Key Variable in Assigning Lipoprotein(a) Cutoff Values for Coronary Heart Disease Risk Assessment: The Multi-Ethnic Study of Atherosclerosis. Arteriosclerosis, Thrombosis and Vascular Biology, 35, 996-1001. https://doi.org/10.1161/ATVBAHA.114.304785
[20]
Nahm, F.S. (2022) Receiver Operating Characteristic Curve: Overview and Practical Use for Clinicians. Korean Journal of Anesthesiology, 75, 25-36. https://doi.org/10.4097/kja.21209
