Ferreira JP, Rossignol P, Bakris G, et al. - Findings revealed blood kidney injury molecule 1 (KIM-1) as the biomarker with the strongest link with worsening kidney function (WKF) in patients with type 2 diabetes post-acute coronary syndrome. WKF occurrence was noted to be independently linked with a higher risk of subsequent cardiovascular events and mortality.

• This analysis involved patients with type 2 diabetes and a recent acute coronary syndrome who took part in the Cardiovascular Outcomes Study of Alogliptin in Patients with Type 2 Diabetes and Acute Coronary Syndrome trial.

• Of 5,131 included patients, 222 (4.3%) experienced at least one WKF episode over a median follow-up of 18 months.

• Blood KIM-1 was (by far) revealed as the variable with strongest WKF association, followed by anemia, in multivariable models incorporating all variables (clinical and biomarkers) independently related to WKF with a p value ≤0.0001.

• A good discrimination for WKF prediction, with area under the curve of 0.73, was offered by KIM-1 alone.

• A 6.7-fold higher risk of any WKF was found in patients in the high KIM-1-derived risk tertile vs patients classified as low risk.

• Time-updated Cox models showed that WKF occurrence was independently related to a higher risk of death: adjusted hazard ratio = 4.93.