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Neopterin, reflecting interferon\u2010\u03b3\u2010release, may better reflect the proinflammatory state of recipients than less specific markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Kidney transplant recipients in the Assessment of LEscol in Renal Transplant (<jats:styled-content style=\"fixed-case\">ALERT<\/jats:styled-content>) trial were examined and investigated for an association between serum neopterin and subsequent clinical events: graft loss, major cardiovascular events (<jats:styled-content style=\"fixed-case\">MACE<\/jats:styled-content>) and all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After adjustment for established and emerging risk factors neopterin expressed as neopterin\u2010to\u2010creatinine ratio was significantly associated with <jats:styled-content style=\"fixed-case\">MACE<\/jats:styled-content> (p\u00a0=\u00a00.009) and all\u2010cause mortality (p\u00a0=\u00a00.002). Endpoints were more frequent with increasing quartiles of neopterin\u2010to\u2010creatinine ratio. The incidence rates of <jats:styled-content style=\"fixed-case\">MACE<\/jats:styled-content> and all\u2010cause mortality were significantly increased in the upper quartiles compared with the first.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This long\u2010term prospective analysis in stable kidney allograft recipients suggests that neopterin is associated with long\u2010term risk of cardiovascular events and all\u2010cause mortality, but not renal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.12285","type":"journal-article","created":{"date-parts":[[2013,12,24]],"date-time":"2013-12-24T07:50:49Z","timestamp":1387871449000},"page":"111-119","source":"Crossref","is-referenced-by-count":11,"title":["Neopterin is associated with cardiovascular events and all\u2010cause mortality in renal transplant patients"],"prefix":"10.1111","volume":"28","author":[{"given":"Hege","family":"Pihlstr\u00f8m","sequence":"first","affiliation":[{"name":"Department of Organ Transplantation Oslo University Hospital Rikshospitalet Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geir","family":"Mj\u00f8en","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine Oslo University Hospital Ullev\u00e5l Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfried","family":"M\u00e4rz","sequence":"additional","affiliation":[{"name":"Clinical Institute of Medical and Chemical Laboratory Diagnostics Medical University of Graz Graz Austria"},{"name":"Synlab Center of Laboratory Diagnostics Heidelberg Germany"},{"name":"Medical Faculty Mannheim Mannheim Institute of Public Health, Social and Preventive Medicine University of Heidelberg Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dag","family":"Olav Dahle","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Oslo University Hospital Rikshospitalet Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadollah","family":"Abedini","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine Sykehuset i Vestfold T\u00f8nsberg Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingar","family":"Holme","sequence":"additional","affiliation":[{"name":"Department of Research and Development Oslo University Hospital Ullev\u00e5l Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bengt","family":"Fellstr\u00f6m","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine Uppsala University Hospital Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Jardine","sequence":"additional","affiliation":[{"name":"British Heart Foundation Glasgow Cardiovascular Researh Centre Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Pilz","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism Department of Internal Medicine Medical University of Graz Graz Austria"},{"name":"Department of Epidemiology and Biostatistics EMGO Institute for Health and Care Research VU University Medical Centre Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hallvard","family":"Holdaas","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Oslo University Hospital Rikshospitalet Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,12,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13638-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2005.01105.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61334-2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00930209"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.2174\/1389200024605109"},{"key":"e_1_2_7_7_1","first-page":"317","article-title":"The biosynthesis of folic acid. 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