Association between plasma chromogranin A concentration and long-term mortality after myocardial infarction.
OBJECTIVE
Chromogranin A, a polypeptide that is distributed throughout the neuroendocrine system, may be a marker of neuroendocrine activation. We sought to assess the long-term prognostic value of circulating levels of chromogranin A after myocardial infarction.


METHODS
We studied 119 patients (88 [74%] male; median age, 70 years [interquartile range, 62 to 75 years]) with documented myocardial infarction. Chromogranin A levels in plasma were determined by radioimmunoassay from samples obtained 3 days after the onset of symptoms.


RESULTS
During a median follow-up of 10.8 years, 56 patients (47%) died. The median concentration of chromogranin A in plasma was 24 ng/mL (interquartile range, 18 to 36 ng/mL). Plasma chromogranin A levels were associated with increased long-term mortality (hazard ratio [HR] = 1.17 per 10-ng/mL increase; 95% confidence interval [CI]: 1.06 to 1.28) in models that adjusted for age, clinical heart failure during the initial hospitalization, and use of thrombolytic therapy. As a dichotomous variable (cutoff, 24 ng/mL), an elevated chromogranin A level was also associated with mortality in univariate analysis (HR = 2.6; 95% CI: 1.4 to 4.8), but this relation was no longer significant after adjustment for age (HR = 1.4; 95% CI: 0.8 to 2.7).


CONCLUSIONS
Plasma levels of chromogranin A are related to long-term mortality after myocardial infarction, perhaps because they reflect neuroendocrine activation.
Omland
Torbjørn
T
Department of Cardiology, The National Hospital, Oslo, Norway. torbjorn.omland@rikshospitalet.no
Dickstein
Kenneth
K
Syversen
Unni
U
D000368:Aged; D053379:Chromogranin A; D002864:Chromogranins / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality; D011379:Prognosis; D016019:Survival Analysis
C506150:CHGA protein, human; D053379:Chromogranin A; D002864:Chromogranins