Mechanisms of cardiovascular complications in chronic kidney disease: research focus of the Transregional Research Consortium SFB TRR219 of the University Hospital Aachen (RWTH) and the Saarland University

Noels, Heidi; Jankowski, Joachim; Floege, Jürgen; Fliser, Danilo; Böhm, Michael

doi:10.1007/s00392-018-1260-0

Cited by 17 publications

(15 citation statements)

References 59 publications

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“…The prospective COMBO Stent registry, for instance, included 3614 patients and documented TLF in 3.9%, cardiac death in 1.6%, and definite stent thrombosis in 0.5% (versus 3.3%, 1.4%, and 0.4% herein) [25][26][27][28][29][30]. Although complication rates were relatively low in general, patients with CKD had a higher risk of major and minor bleeding as well as access site-related complications leading to prolonged hospitalization and higher rates of end points at discharge (supplement Table 1), which is in line with previous publications [28][29][30][31][32]. Bleeding occurred in 2.3% of all included patients, with twofold higher rates of minor and major bleeding in CKD.…”

Section: Discussionsupporting

confidence: 87%

One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry

et al. 2019

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Background Chronic kidney disease (CKD) is highly prevalent in patients with coronary artery disease (CAD). Objective The outcome following revascularization using contemporary technologies (new-generation abluminal sirolimuseluting stents with thin struts) in patients with CKD (i.e., glomerular filtration rate of < 60 mL/min/1.73m 2 ) and in patients with hemodialysis (HD) is unknown. Methods e-Ultimaster is a prospective, single-arm, multi-center registry with clinical follow-up at 3 months and 1 year. Results A total of 19,475 patients were enrolled, including 1466 patients with CKD, with 167 undergoing HD. Patients with CKD had a higher prevalence of overall comorbidities, multiple/small vessel disease (≤ 2.75 mm), bifurcation lesions, and more often left main artery treatments (all p < 0.0001) when compared with patients with normal renal function (reference). CKD patients had a higher risk of target lesion failure (unadjusted OR, 2.51 [95% CI 2.04-3.08]), target vessel failure (OR, 2.44 [95% CI 2.01-2.96]), patient-oriented composite end point (OR, 2.19 [95% CI 1.87-2.56]), and major adverse cardiovascular events (OR, 2.34 [95% CI 1.93-2.83, p for all < 0.0001]) as reference. The rates of target lesion revascularization (OR, 1.17 [95% CI 0.79-1.73], p = 0.44) were not different. Bleeding complications were more frequently observed in CKD than in the reference (all p < 0.0001). Conclusion In this worldwide registry, CKD patients presented with more comorbidities and more complex lesions when compared with the reference population. They experienced higher rate of adverse events at 1-year follow-up.

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Section: Discussionsupporting

confidence: 87%

One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry

et al. 2019

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“…Recently, a pilot study revealed that CXCR4-directed 68 Ga-Pentixa for PET/CT identified more lesions than 18 F-FDG PET/CT [74]. In addition, 111 In-DOTA-DAPTA (CCR5 antagonist) has been shown to detect atherosclerotic lesions in Apoe − /− mice, suggesting that 111 In-DOTA-DAPTA can specifically target CCR5 in atherosclerotic lesions [75]. All these findings suggest that chemokines and chemokine like mimetics may be useful to assess individual atherosclerotic burden, as a surrogate marker for CAD screening or a predictor of clinical cardiovascular events and may function as imaging tracers for a better understanding of characteristics of atherosclerotic lesions.…”

Section: Biomarkers and Imaging Tools For Diagnosis And Prognosismentioning

confidence: 99%

Targeting the chemokine network in atherosclerosis

Thakur

Vorst

et al. 2021

Atherosclerosis

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Chemokines and their receptors represent a potential target for immunotherapy in chronic inflammation. They comprise a large family of cytokines with chemotactic activity, and their cognate receptors are expressed on all cells of the body. This network dictates leukocyte recruitment and activation, angiogenesis, cell proliferation and maturation. Dysregulation of chemokine and chemokine receptor expression as well as function participates in many pathologies including cancer, autoimmune diseases and chronic inflammation. In atherosclerosis, a lipiddriven chronic inflammation of middle-sized and large arteries, chemokines and their receptors participates in almost all stages of the disease from initiation of fatty streaks to mature atherosclerotic plaque formation. Atherosclerosis and its complications are the main driver of mortality and morbidity in cardiovascular diseases (CVD). Hence, exploring new fields of therapeutic targeting of atherosclerosis is of key importance. This review gives an overview of the recent advances on the role of key chemokines and chemokine receptors in atherosclerosis, addresses chemokine-based biomarkers at biochemical, imaging and genetic level in human studies, and highlights the clinial trials targeting atherosclerosis.

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“…CV calcification could be one of the key mechanisms leading to increased CVD in Modifications in the circulation as well as in the myocardium are crucially involved in the increased CV risk in CKD patients. However, both the mediators and the underlying molecular mechanisms remain largely unexplored [12]. CV calcification-both in the tunica intima and in the media-is massively increased in CKD patients and is an independent risk factor for CV morbidity and mortality [13].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Calcification in Chronic Kidney Disease—Therapeutic Opportunities

Himmelsbach

Ciliox

Goettsch

2020

Toxins

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Patients with chronic kidney disease (CKD) are highly susceptible to cardiovascular (CV) complications, thus suffering from clinical manifestations such as heart failure and stroke. CV calcification greatly contributes to the increased CV risk in CKD patients. However, no clinically viable therapies towards treatment and prevention of CV calcification or early biomarkers have been approved to date, which is largely attributed to the asymptomatic progression of calcification and the dearth of high-resolution imaging techniques to detect early calcification prior to the ‘point of no return’. Clearly, new intervention and management strategies are essential to reduce CV risk factors in CKD patients. In experimental rodent models, novel promising therapeutic interventions demonstrate decreased CKD-induced calcification and prevent CV complications. Potential diagnostic markers such as the serum T50 assay, which demonstrates an association of serum calcification propensity with all-cause mortality and CV death in CKD patients, have been developed. This review provides an overview of the latest observations and evaluates the potential of these new interventions in relation to CV calcification in CKD patients. To this end, potential therapeutics have been analyzed, and their properties compared via experimental rodent models, human clinical trials, and meta-analyses.

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Mechanisms of cardiovascular complications in chronic kidney disease: research focus of the Transregional Research Consortium SFB TRR219 of the University Hospital Aachen (RWTH) and the Saarland University

Cited by 17 publications

References 59 publications

One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry

One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry

Targeting the chemokine network in atherosclerosis

Cardiovascular Calcification in Chronic Kidney Disease—Therapeutic Opportunities

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