Brain-Derived Neurotrophic Factor Reduces Long-Term Mortality in Patients With Coronary Artery Disease and Chronic Kidney Disease

<jats:sec><jats:title>Objectives</jats:title><jats:p>Chronic kidney disease (CKD) is a risk factor for coronary artery disease (CAD). We examined the effects of circulating brain-derived neurotrophic factor (BDNF) on long-term mortality in patients with CAD and CKD.</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>We enrolled patients with established CAD in the present study. Serum BDNF and estimated glomerular filtration rate (eGFR) were assessed after overnight fasting. All-cause mortality served as the primary endpoint.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>All 348 enrolled patients were divided into four groups according to their median BDNF level and CKD status, defined according to eGFR &lt;60 mL/min/1.73 m<jats:sup>2</jats:sup>. Forty-five patients reached the primary endpoint during the median follow-up time of 6.0 years. Kaplan-Meier survival analysis indicated that the group with low BDNF and CKD had a significantly higher mortality rate than the other three groups (log-rank test <jats:italic>p</jats:italic> &lt; 0.001). Compared to the high BDNF without CKD group, the low BDNF with CKD group had a hazard ratio (HR) of 3.186 [95% confidence interval (CI): 1.482–6.846] for all-cause mortality according to the multivariable Cox proportional hazard regression analysis after adjusting for age and urine albumin-creatinine ratio (<jats:italic>p</jats:italic> = 0.003). Furthermore, there was a significantly interactive effect between BDNF and CKD status on the risk of the primary endpoint (odds ratio = 6.413, 95% CI: 1.497–27.47 in the multivariable logistic regression model and HR = 3.640, 95% CI: 1.006–13.173 in the Cox regression model).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>We observed a synergistic effect between low serum BDNF levels and CKD on the prediction of all-cause mortality in patients with CAD.</jats:p></jats:sec>