Predictive value of sST2,FGF-23 and sCD40L for cardiovascular events in patientson maintenance hemodialysis

Objective To explore the predictive values of soluble growth-stimulation expressed gene protein 2(sST2), fibroblast growth factor 23(FGF-23) and soluble CD40 ligand(sCD40L) for the occurrence of cardiovascular events in patients on maintenance hemodialysis(MHD). Methods For this retrospective cohort study at a single center, 80 patients on MHD over 6 months between February 2015 and December 2019 were assigned into study group. They were followed up until June 2020. According to the presence or absence of cardiovascular events, they were divided into two groups of cardiovascular event(n=29) and non-cardiovascular event(n=51). During the same period, 40 healthy controls were selected as control group. The serum levels of sST2, FGF-23 and sCD40L were detected and compared among all groups. The relevant influencing factors of cardiovascular events were analyzed by univariate and multivariate Logistic regression analyses. The curves of receiver operating characteristic(ROC) were plotted for analyzing the predictive values of sST2, FGF-23 and sCD40L for cardiovascular events. Results The serum levels of sST2, FGF-23 and sCD40L were higher in study group than those in control group(P<0. 05). Age, dialysis age, levels of sST2, FGF-23 and sCD40L were higher in cardiovascular event group than those in non-cardiovascular event group(P<0. 05). Logistic regression analysis indicated that age ≥ 60 years, dialysis age ≥ 38 months and elevated levels of sST2, FGF-23 and sCD40L were independent risk factors of cardiovascular events in MHD patients(P<0. 05). And ROC curves revealed that area under curve(AUC) of serum levels of sST2 plus FGF-23 and sCD40L was 0. 901 for predicting cardiovascular events. It was higher than that of them alone(0. 769, 0. 752, 0. 728) (P<0. 05). Conclusion Elevated in MHD patients with cardiovascular events, the serum levels of sST2, FGF-23 and sCD40L have some predictive values for cardiovascular events.