Kynurenine as a Predictor of Long-Term Mortality: A 10-Year Follow-Up from the KORONEF Registry
<b>Background</b>: The kynurenine (KYN) pathway of tryptophan metabolism has been linked to inflammation and cardiovascular risk, but its long-term prognostic value remains unclear. <b>Methods</b>: We analyzed 492 patients from the KORONEF registry who underwent coronary and...
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2025-05-01
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| author | Adam Kern Tomasz Stompór Krystian Bojko Ewa Sienkiewicz Sebastian Pawlak Krystyna Pawlak Dariusz Pawlak Grzegorz Poskrobko Ewa Andrasz Leszek Gromadziński Rakesh Jalali Dariusz Onichimowski Grażyna Piwko Artur Zalewski Jacek Bil |
| author_facet | Adam Kern Tomasz Stompór Krystian Bojko Ewa Sienkiewicz Sebastian Pawlak Krystyna Pawlak Dariusz Pawlak Grzegorz Poskrobko Ewa Andrasz Leszek Gromadziński Rakesh Jalali Dariusz Onichimowski Grażyna Piwko Artur Zalewski Jacek Bil |
| author_sort | Adam Kern |
| collection | DOAJ |
| description | <b>Background</b>: The kynurenine (KYN) pathway of tryptophan metabolism has been linked to inflammation and cardiovascular risk, but its long-term prognostic value remains unclear. <b>Methods</b>: We analyzed 492 patients from the KORONEF registry who underwent coronary and renal angiography and were followed for a median of 10.2 years. Plasma levels of tryptophan (TRP), KYN, and downstream metabolites were measured. The primary endpoint was all-cause mortality. <b>Results</b>: The mean age was 64.4 ± 9.9 years, and 37.2% of patients were female. Common comorbidities included hypertension (74.8%), dyslipidemia (46.0%), and diabetes (25.8%). Overall mortality reached 29.5% and increased across KYN tertiles: 17.6% (T1), 28.2% (T2), and 42.9% (T3) (<i>p</i> < 0.001). In a multivariable Cox analysis, KYN independently predicted mortality (HR: 1.79; 95% CI: 1.15–2.44; <i>p</i> < 0.001), alongside age, diabetes, prior myocardial infarction, chronic kidney disease, and left ventricular ejection fraction. Other kynurenine pathway metabolites were not independently associated with outcomes. <b>Conclusions</b>: Elevated kynurenine levels independently predict 10-year all-cause mortality in patients undergoing coronary angiography. KYN may represent a useful prognostic biomarker beyond traditional clinical and angiographic variables. |
| format | Article |
| id | doaj-art-ce86f05b0e1a4e26a3fe71bdc2ecc46c |
| institution | Kabale University |
| issn | 2227-9059 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
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| series | Biomedicines |
| spelling | doaj-art-ce86f05b0e1a4e26a3fe71bdc2ecc46c2025-08-20T03:47:50ZengMDPI AGBiomedicines2227-90592025-05-01135112310.3390/biomedicines13051123Kynurenine as a Predictor of Long-Term Mortality: A 10-Year Follow-Up from the KORONEF RegistryAdam Kern0Tomasz Stompór1Krystian Bojko2Ewa Sienkiewicz3Sebastian Pawlak4Krystyna Pawlak5Dariusz Pawlak6Grzegorz Poskrobko7Ewa Andrasz8Leszek Gromadziński9Rakesh Jalali10Dariusz Onichimowski11Grażyna Piwko12Artur Zalewski13Jacek Bil14Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-727 Olsztyn, PolandDepartment of Nephrology, Hypertension and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-727 Olsztyn, PolandDepartment of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-727 Olsztyn, PolandDepartment of Cardiology, Regional Specialist Hospital in Olsztyn, 10-045 Olsztyn, PolandDepartment of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-727 Olsztyn, PolandDepartment of Monitored Pharmacotherapy, Medical University of Bialystok, 15-089 Bialystok, PolandDepartment of Pharmacodynamics, Medical University of Bialystok, 15-089 Bialystok, PolandDepartment of Cardiology, Regional Specialist Hospital in Olsztyn, 10-045 Olsztyn, PolandDepartment of Cardiology, Regional Specialist Hospital in Olsztyn, 10-045 Olsztyn, PolandDepartment of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-727 Olsztyn, PolandDepartment of Emergency Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-727 Olsztyn, PolandDepartment of Emergency Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-727 Olsztyn, PolandDepartment of Cardiology, University of Warmia and Mazury in Olsztyn, Branch in Ełk, 19-300 Ełk, PolandScanmed Cardiology Center in Ełk, 19-300 Ełk, PolandNational Medical Institute of the Ministry of Interior and Administration, 02-507 Warsaw, Poland<b>Background</b>: The kynurenine (KYN) pathway of tryptophan metabolism has been linked to inflammation and cardiovascular risk, but its long-term prognostic value remains unclear. <b>Methods</b>: We analyzed 492 patients from the KORONEF registry who underwent coronary and renal angiography and were followed for a median of 10.2 years. Plasma levels of tryptophan (TRP), KYN, and downstream metabolites were measured. The primary endpoint was all-cause mortality. <b>Results</b>: The mean age was 64.4 ± 9.9 years, and 37.2% of patients were female. Common comorbidities included hypertension (74.8%), dyslipidemia (46.0%), and diabetes (25.8%). Overall mortality reached 29.5% and increased across KYN tertiles: 17.6% (T1), 28.2% (T2), and 42.9% (T3) (<i>p</i> < 0.001). In a multivariable Cox analysis, KYN independently predicted mortality (HR: 1.79; 95% CI: 1.15–2.44; <i>p</i> < 0.001), alongside age, diabetes, prior myocardial infarction, chronic kidney disease, and left ventricular ejection fraction. Other kynurenine pathway metabolites were not independently associated with outcomes. <b>Conclusions</b>: Elevated kynurenine levels independently predict 10-year all-cause mortality in patients undergoing coronary angiography. KYN may represent a useful prognostic biomarker beyond traditional clinical and angiographic variables.https://www.mdpi.com/2227-9059/13/5/1123kynureninetryptophancardiovascular diseasemortalitycoronary angiographybiomarkers |
| spellingShingle | Adam Kern Tomasz Stompór Krystian Bojko Ewa Sienkiewicz Sebastian Pawlak Krystyna Pawlak Dariusz Pawlak Grzegorz Poskrobko Ewa Andrasz Leszek Gromadziński Rakesh Jalali Dariusz Onichimowski Grażyna Piwko Artur Zalewski Jacek Bil Kynurenine as a Predictor of Long-Term Mortality: A 10-Year Follow-Up from the KORONEF Registry Biomedicines kynurenine tryptophan cardiovascular disease mortality coronary angiography biomarkers |
| title | Kynurenine as a Predictor of Long-Term Mortality: A 10-Year Follow-Up from the KORONEF Registry |
| title_full | Kynurenine as a Predictor of Long-Term Mortality: A 10-Year Follow-Up from the KORONEF Registry |
| title_fullStr | Kynurenine as a Predictor of Long-Term Mortality: A 10-Year Follow-Up from the KORONEF Registry |
| title_full_unstemmed | Kynurenine as a Predictor of Long-Term Mortality: A 10-Year Follow-Up from the KORONEF Registry |
| title_short | Kynurenine as a Predictor of Long-Term Mortality: A 10-Year Follow-Up from the KORONEF Registry |
| title_sort | kynurenine as a predictor of long term mortality a 10 year follow up from the koronef registry |
| topic | kynurenine tryptophan cardiovascular disease mortality coronary angiography biomarkers |
| url | https://www.mdpi.com/2227-9059/13/5/1123 |
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