Association of endogenous erythropoietin with 10-year risk of all-cause and cardiovascular mortality.

Abstract

Background and aims: Whether endogenous erythropoietin (EPO) levels are associated with all-cause and cardiovascular mortality in the general population is still unknown. This study investigated the relationship between the endogenous EPO level and the risks of all-cause and cardiovascular mortality in a community-based population.

Methods and results: A total of 4870 community-dwelling Chinese participants with no history of stroke or myocardial infarction were enrolled. The association of endogenous EPO levels with all-cause and cardiovascular mortality was determined using smoothed fitting curves and Cox proportional hazards models. The mean age was 56.72 ± 8.78 years. During a mean follow-up of 9.68 years, 271 (5.56 %) died, of which 84 (1.72 %) experienced cardiovascular death. After adjustment for risk factors, the risk of all-cause mortality was significantly higher in the fourth quintile (hazard ratio [HR] 1.80, 95 % confidence interval [CI] 1.21-2.68, P = 0.012) and highest quintile (HR 1.67, 95 % CI 1.12-2.49, P = 0.004) for EPO than in the middle quintile. The lowest quintile (HR 1.47, 95 % CI 0.95-2.28, P = 0.083) and second quintile (HR 1.49, 95 % CI 0.98-2.28, P = 0.064) showed a non-significant increased risk. Additionally, the risk of cardiovascular mortality was significantly higher in the highest quintile than in the middle quintile (HR 2.18, 95 % CI 1.08-4.39, P = 0.029).

Conclusion: The risks of cardiovascular and all-cause mortality were significantly increased in individuals with elevated endogenous EPO. Lower endogenous EPO levels were also associated with a non-significant increased risk. Further research is needed to elucidate the mechanisms underlying these findings.