Brain-Derived Neurotrophic Factor Reduces Long-Term Mortality in Patients With Coronary Artery Disease and Chronic
Cheng-Yueh Hsu1,2, Wayne Huey-Herng Sheu3,4, I-Te Lee4,5,6
1Master of Public Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
Insights
Low brain-derived neurotrophic factor (BDNF) combined with chronic kidney disease (CKD) significantly increases long-term mortality risk in coronary artery disease (CAD) patients. This synergistic effect highlights BDNF and CKD as crucial predictors for adverse outcomes.
Area of Science:
- Cardiology
- Nephrology
- Biomarkers
Background:
- Chronic kidney disease (CKD) is an established risk factor for coronary artery disease (CAD).
- Brain-derived neurotrophic factor (BDNF) is a neurotrophin with potential roles in cardiovascular health.
- The combined impact of BDNF levels and CKD on mortality in CAD patients remains under-investigated.
Purpose of the Study:
- To investigate the effect of circulating brain-derived neurotrophic factor (BDNF) on long-term mortality in patients with coronary artery disease (CAD) and chronic kidney disease (CKD).
Main Methods:
- A cohort of 348 patients with established CAD was enrolled.
- Serum BDNF levels and estimated glomerular filtration rate (eGFR) were measured.
- All-cause mortality was tracked over a median follow-up of 6.0 years.
Main Results:
- Patients with both low BDNF and CKD exhibited significantly higher mortality rates compared to other groups (log-rank test p < 0.001).
- Low BDNF with CKD was associated with a 3.186-fold increased hazard ratio for all-cause mortality (p = 0.003) after multivariable adjustment.
- A significant interaction between BDNF and CKD status was observed, predicting mortality risk.
Conclusions:
- A synergistic adverse effect exists between low serum BDNF levels and CKD in predicting all-cause mortality among patients with CAD.
- These findings suggest BDNF and CKD status are important prognostic indicators in CAD management.
Objectives:
Chronic kidney disease (CKD) is a risk factor for coronary artery disease (CAD). We examined the effects of circulating brain-derived neurotrophic factor (BDNF) on long-term mortality in patients with CAD and CKD.
Materials And Methods:
We enrolled patients with established CAD in the present study. Serum BDNF and estimated glomerular filtration rate (eGFR) were assessed after overnight fasting. All-cause mortality served as the primary endpoint.
Results:
All 348 enrolled patients were divided into four groups according to their median BDNF level and CKD status, defined according to eGFR <60 mL/min/1.73 m2. Forty-five patients reached the primary endpoint during the median follow-up time of 6.0 years. Kaplan-Meier survival analysis indicated that the group with low BDNF and CKD had a significantly higher mortality rate than the other three groups (log-rank test p < 0.001). Compared to the high BDNF without CKD group, the low BDNF with CKD group had a hazard ratio (HR) of 3.186 [95% confidence interval (CI): 1.482-6.846] for all-cause mortality according to the multivariable Cox proportional hazard regression analysis after adjusting for age and urine albumin-creatinine ratio (p = 0.003). Furthermore, there was a significantly interactive effect between BDNF and CKD status on the risk of the primary endpoint (odds ratio = 6.413, 95% CI: 1.497-27.47 in the multivariable logistic regression model and HR = 3.640, 95% CI: 1.006-13.173 in the Cox regression model).
Conclusion:
We observed a synergistic effect between low serum BDNF levels and CKD on the prediction of all-cause mortality in patients with CAD.
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