The Association between Polyclonal Combined Serum Free Light Chain Concentration and Mortality in Individuals with Early XXXX .

@entity1 @entity32 @entity1581 @entity470 @entity740 @entity1851
UNASSIGNED: A major component of increased mortality risk in @entity1 with @entity740 ( @entity740 ) is associated with non-traditional cardiovascular risk factors including markers of @entity32 . We studied whether a novel marker of systemic @entity32 , elevated serum combined polyclonal immunoglobulin free light chains (cFLC), was an independent risk factor for increased all-cause mortality in @entity1 with @entity740 stage 3. In a prospective community based cohort study, 1695 @entity1 with stage 3 @entity740 and no cases of @entity1581 had cFLC concentrations measured. cFLC levels were determined using the summation of Freelite kappa and lambda assays. All other bioclinical variables were collected at the time of sample collection. Kaplan-Meier plots and Cox proportional hazards analysis was used to assess the relationship between high cFLC levels (>43.3 mg/L) and mortality. There were 167 deaths (10%) after a median of 1375 days. cFLC levels at recruitment were higher in @entity1 who died compared with those who were alive at the end of the study; median: 46.5 mg/L (IQR: 36.1-65.4 mg/L) and 35.4 mg/L (28.1-46.6 mg/L) respectively, P <0.001. Kaplan-Meier survival analysis demonstrated @entity1 with cFLC >43.3 mg/L levels had an increased risk of mortality compared to @entity1 with normal cFLC levels (P <0.001). Elevated cFLC levels were independently associated with worse survival (Hazard ratio: 1.50; 95% confidence interval: 1.04-2.16; P=0.03). Other independent risk factors for worse survival were: older age, male gender, previous cardiovascular event, lower @entity470 and higher high sensitivity @entity1851 (hsCRP). To conclude, high cFLC levels predict increased mortality in @entity1 with stage 3 @entity740 , independent of established risk factors and other markers of @entity32 .
