PB0031 - Natural antibodies to oxidation-specific epitopes characterize hemodialysis patients protected from cardiovascular events

Sunday, June 25, 2023

18:30 – 19:30 ET

Room: Exhibition

Presenting Author(s)

Rafaela Vostatek, MSc

PhD student
Medical University of Vienna
Vienna, Wien, Austria

Co-Author(s)

TA

Taras Afonyushkin

Principal Investigator
Medical University of Vienna
Vienna, Wien, Austria
MO

Maria Ozsvar Kozma

Technical Assistant, Lab Manager
Medical University of Vienna
Vienna, Wien, Austria
SS

Sabine Schmaldienst

Medical Doctor
Department of Medicine I, Clinic Favoriten
Vienna, Wien, Austria
ML

Matthias Lorenz

Medical Doctor
Vienna Dialysis Center, Vienna, Austria
Vienna, Wien, Austria
RK

Renate Klauser-Braun

Medical Doctor
Department of Medicine III, Clinic Donaustadt
Vienna, Wien, Austria
Ingrid Pabinger, MD

Co-Head of the Thrombosis and Haemostasis Research Group
Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
Vienna, Wien, Austria
MS

Marcus Säemann

Medical Doctor
Department of Medicine VI, Clinic Ottakring
Vienna, Wien, Austria
Cihan Ay, MD (he/him/his)

Professor, Head of the Thrombosis and Haemostasis Research Group
Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
Vienna, Wien, Austria
CB

Christoph J. Binder

Professor
Medical University of Vienna
Vienna, Wien, Austria
OK

Oliver Königsbrügge

Resident physician
Medical University of Vienna
Vienna, Wien, Austria

Background: Patients with end-stage kidney disease (ESKD) on hemodialysis (HD) are at increased risk of cardiovascular disease. HD is associated with increased oxidative stress and natural antibodies to oxidation-specific epitopes (OSE) have protective properties against thromboembolic events.

Aims: We aimed to elucidate the role of natural antibodies to OSE in a cohort of ESKD patients on HD, who are at high risk of cardiovascular events.

Methods: We measured serum levels of immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies to different types of model antigens for OSE, including copper-oxidized low-density lipoproteins (CuOx-LDL), malondialdehyde-modified LDL (MDA-LDL), malondialdehyde-acetaldehyde modified BSA (MAA-BSA) by ELISA in 596 patients with ESKD on HD included in a prospective population-based cohort study, who provided informed consent. Major adverse cardiovascular events (MACE) were defined as the composite of myocardial infarction, ischemic stroke, and cardiovascular death.

Results: We included 596 patients (226 female, median age 66 years) and the median time on hemodialysis was 2.7 years. 52 patients (8.7%) had time on HD >10 years and were defined as super-survivors. During a median follow-up of 870 days, 136 patients (22.8%) had MACE, 40 patients (6.7%) with stroke, 36 patients (6.0%) had myocardial infarction, and 98 patients (16.4%) died of cardiovascular death. All-cause death was recorded in 243 patients (40.8%).

We found that HD patients with and without MACE did not significantly differ in levels of IgG and IgM against OSE (table 1). Super-survivors, however, had higher levels of IgG and IgM compared to patients with MACE, MAA-BSA-IgG (p=0.007) reaching statistical significance. Super-survivors also had higher MDA-LDL-IgM levels (p=0.047), MDA-LDL-IgG (p=0.031), and MAA-BSA-IgG levels (p=0.001) compared to patients without cardiovascular events during the observation (table 1).

Conclusion(s): We observed that high levels of IgG and IgM against OSE are characteristic to a phenotype of ESKD patients on HD with a lower risk of cardiovascular events.