Klotho: Potential Marker of High Cardiovascular Risk in Patients With Acute Coronary Syndrome and Chronic Kidney Disease

Aisulu S. Zhunuspekova, Andrey Yu. Orekhov, Jamilya Mansurova, Assel Chinybayeva, Lyudmila K. Karazhanova

2025

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.1007/s44411-025-00085-w
Data confidence 70 medium
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Abstract

Abstract Aim Recently it was established that the deficit of Klotho morphogenetic protein in serum is one of the most likely predictors of cardiovascular mortality. Purpose of the Study to examine the association of Klotho with adverse prognosis factors in patients with acute non-ST-segment elevation myocardial infarction and chronic kidney disease. Materials and Methods of the Study The analysis included patients with acute myocardial infarction without ST-segment elevation and chronic kidney disease. Inclusion criteria: AMI without persistent ST-segment elevation that underwent coronary artery stenting after coronary angiography; presence of chronic kidney disease diagnosed as a decrease in glomerular filtration rate less than 60 ml/min/1.73m2. Exclusion criteria: terminal CKD or patients on program hemodialysis, presence of acute kidney injury, cancer, refusal to participate in the study. Results Initial analysis showed that decreased Klotho levels were common among elderly patients, and among these patients there was more frequent history of myocardial revascularization, as well as a higher risk of adverse events according to the GRACE scale. The association of Klotho level with three cardiovascular complications risk factors—age (β = −9.884 (SD 1.667), p = 0.000), C-reactive protein level (β = −0.661 (SD 0.205), p = 0.002) and troponin (β = −0.07 (SD 0.031), p = 0.026)—was determined by multiple linear regression method. Conclusion The prospective study demonstrated that Klotho may act as one of the markers of cardiovascular risk in patients with non-ST elevation myocardial infarction and chronic kidney disease. Its independent association with three risk factors of cardiovascular risk – age, C-reactive protein level and troponin was established.