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CD14(++)CD16+ monocytes but not total monocyte numbers predict cardiovascular events in dialysis patients
G H Heine1, C Ulrich, E Seibert
1Department of Nephrology, University of Saarland, Homburg/Saar, Germany. inghei@uniklinik-saarland.de
Insights
High numbers of CD14(++)CD16(+) monocytes, a specific subset, predict cardiovascular events and death in dialysis patients. Total monocyte counts did not show predictive value for event-free survival.
Area of Science:
- Cardiovascular Science
- Immunology
- Nephrology
Background:
- Monocyte migration into vessel walls is key in atherosclerosis development.
- Monocytes are heterogeneous, with distinct subsets potentially linked to disease outcomes.
- Dialysis patients represent a high-risk group for cardiovascular events.
Purpose of the Study:
- To investigate the association between monocyte subsets and cardiovascular events in dialysis patients.
- To determine if specific monocyte subsets can predict cardiovascular events and death.
Main Methods:
- Prospective cohort study of 94 dialysis patients followed for 35 months.
- Flow cytometry used for monocyte subset analysis.
- Kaplan-Meier plots and multivariate proportional hazards models employed for statistical analysis.
Main Results:
- Total leukocyte and monocyte counts did not predict event-free survival.
- Elevated CD14(++)CD16(+) monocyte numbers were associated with increased rates of cardiovascular events and death.
- Patients in the highest quartile of CD14(++)CD16(+) monocytes showed significantly higher risk.
Conclusions:
- CD14(++)CD16(+) monocyte count is an independent predictor of cardiovascular events and death in dialysis patients.
- This monocyte subset may serve as a valuable biomarker in high-risk populations.
Abstract:
Migration of monocytes into the vessel wall contributes to the onset and progression of atherosclerosis. Because monocytes are a heterogeneous population, we determined potential associations between monocyte subsets and cardiovascular events in a prospective cohort of 94 dialysis patients followed for 35 months. The incidence of cardiovascular events and death measured by Kaplan-Meier plots and flow cytometric analysis of monocyte subsets showed that total leukocyte and monocyte numbers failed to predict event-free survival. Among monocyte subsets, a high CD14(++)CD16(+) monocyte number was associated with higher rates of cardiovascular events and death. In a multivariate proportional hazards model adjusted for classical cardiovascular risk factors, patients with CD14(++)CD16(+) monocyte numbers in the top quartile were at higher risk of cardiovascular events and death compared to patients in the lowest quartile. Our study suggests that the number of CD14(++)CD16(+) monocytes was independently associated with cardiovascular events and death in a high-risk population of dialysis patients.
