Impact of plasma aldosterone levels for prediction of in-stent restenosis.
Aldosterone promotes vascular smooth muscle cell proliferation and endothelial dysfunction, suggesting the contribution to in-stent restenosis (ISR). This study evaluated any relation between plasma aldosterone levels and ISR 6 months after successful coronary stenting. We enrolled 156 consecutive patients with stable angina who underwent coronary bare metal stenting. Plasma aldosterone levels and other serum markers known to influence cardiovascular events were measured in all patients at baseline. Patients with restenosis were found to have significantly higher plasma aldosterone levels than their counterparts without restenosis (162 +/- 60 vs 122 +/- 60 pg/ml, p = 0.007). On logistic regression analysis, even after adjusting for clinical, angiographic, and other confounding variables, plasma aldosterone level per 10 pg/ml (odds ratio 1.34, 95% confidence interval 1.10 to 1.63, p = 0.006) proved to be the independent predictor of ISR. The area under the receiver-operating characteristic curve for plasma aldosterone level was 0.75, and the optimal cut-off value identified by receiver-operating characteristic analysis was 141.9 pg/ml, which had a predictive accuracy of 69%. In conclusion, the present findings indicate that plasma aldosterone levels at baseline are independent predictors of ISR and may constitute a potential therapeutic target.
Amano
Tetsuya
T
Department of Cardiology, Nagoya University Graduate School of Medicine, Japan. amanot@med.nagoya-u.ac.jp
Matsubara
Tatsuaki
T
Izawa
Hideo
H
Torigoe
Masayuki
M
Yoshida
Tomohiro
T
Hamaguchi
Yukihisa
Y
Ishii
Hideki
H
Miura
Manabu
M
Hayashi
Yuzo
Y
Ogawa
Yasuhiro
Y
Murohara
Toyoaki
T
D000368:Aged; D000450:Aldosterone / Q000097:blood*; D000787:Angina Pectoris / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D008078:Cholesterol, LDL / Q000097:blood; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011183:Postoperative Complications; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D012083:Renin / Q000097:blood; D015607:Stents
D015415:Biomarkers; D008078:Cholesterol, LDL; D020097:Natriuretic Peptide, Brain; D000450:Aldosterone; D005340:Fibrinogen; D002097:C-Reactive Protein; D012083:Renin