title: Circulating surfactant protein-D and the risk of cardiovascular morbidity and mortality.
abstract: OBJECTIVE
  Surfactant protein-D (SP-D) is a lung-specific protein that is detectable in human plasma. We determined the relationship of circulating SP-D to cardiovascular disease (CVD) and total mortality in subjects with and without CVD.
  
  
  RESULTS
  Plasma SP-D levels were measured in 806 patients who underwent coronary angiography to assess its predictive value for cardiovascular mortality. Serum SP-D levels were also measured in a replication cohort to assess its relationship with CVD events in 4468 ex- and current smokers without a known history of coronary artery disease (CAD). Patients who died during follow-up had significantly higher plasma SP-D levels than those who survived (median 85.4 vs. 64.8 ng/mL; P < 0.0001). Those in the highest quintile of SP-D had 4.4-fold higher risk of CVD mortality than those in the lowest quintile (P < 0.0001) independent of age, sex, and plasma lipid levels. In a group of current and ex-smokers without a known history of CAD, serum SP-D levels were elevated in those who died or were hospitalized for CVD compared with those who did not (median 99.8 vs. 90.6 ng/mL; P = 0.0001).
  
  
  CONCLUSIONS
  Circulating SP-D is a good predictor of cardiovascular morbidity and mortality and adds prognostic information to well-established risk factors such as age, sex, and plasma lipids and is a promising biomarker to link lung inflammation/injury to CVD.
authors.affiliation: Providence Heart and Lung Institute and The UBC James Hogg Research Center, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6.
authors.forename: John
authors.initials: J
authors.lastname: Hill
authors.forename: Claire
authors.initials: C
authors.lastname: Heslop
authors.forename: S F Paul
authors.initials: SF
authors.lastname: Man
authors.forename: Jiri
authors.initials: J
authors.lastname: Frohlich
authors.forename: John E
authors.initials: JE
authors.lastname: Connett
authors.forename: Nick R
authors.initials: NR
authors.lastname: Anthonisen
authors.forename: Robert A
authors.initials: RA
authors.lastname: Wise
authors.forename: Donald P
authors.initials: DP
authors.lastname: Tashkin
authors.forename: Don D
authors.initials: DD
authors.lastname: Sin
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000097:blood / Q000401:mortality; D011379:Prognosis; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood*; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D037663:Pulmonary Surfactant-Associated Protein D