Multimarker approach for the prediction of cardiovascular events in patients with mild to moderate coronary artery lesions. A 3-year follow-up study.
Few studies have assessed the incremental usefulness of multimarkers as predictors of cardiovascular events in patients with mild to moderate coronary artery lesions.We examined 9 plasma inflammatory cytokines (cathepsin S, CXCL16, sopluble CD40 ligand, interleukin-10, placental growth factor, GDF15, matrix metalloproteinase 9, monocyte chemoattractant protein-1, and high-sensitivity C-reactive protein) in 964 patients showing mild to moderate lesions and assessed their association with risk of cardiovascular events during 3 years of follow-up (median 17 months).In a backward Cox regression procedure, Cystatin S (hazard ratio [HR]: 1.788, 95% CI: 1.233 to 2.593, P = 0.02), soluble CD40 ligand (HR: 1.255, 95% CI: 1.054 to 1.494, P = 0.011), placental growth factor (HR: 1.194, 95% CI: 0.976 to 1.461, P = 0.035), and GDF15 (HR: 0.725, 95% CI: 0.550 to 0.956, P = 0.023) were significantly related to cardiovascular events. Compared with multimarker score (according to regression coefficients of significant biomarkers) in the lowest two quintiles, patients in the highest quintile had a higher risk of cardiovascular events after adjustment for traditional risk factors (HR: 2.77, 95% CI: 1.30 to 5.87, P = 0.008). Adding the multimarker score to traditional risk factors contributed significantly to the prediction of cardiovascular events (AUC increased from 0.67 to 0.72).A multimarker approach added to the predictive information obtained from traditional risk factors in patients with mild to moderate coronary artery lesions.
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University.
Min
M
Zhang
Shuzheng
S
Lu
Xiaofan
X
Wu
Yundai
Y
Chen
Xiantao
X
Song
Zening
Z
Jin
Hong
H
Li
Yujie
Y
Zhou
Fang
F
Chen
Yong
Y
Huo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood*; D002403:Cathepsins / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood*; D016207:Cytokines / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D055436:Growth Differentiation Factor 15 / Q000097:blood; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D000072483:Placenta Growth Factor; D011237:Predictive Value of Tests; D011257:Pregnancy Proteins / Q000097:blood; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011993:Recombinant Fusion Proteins / Q000097:blood; D012307:Risk Factors; D055815:Young Adult
D015415:Biomarkers; C526581:CD40LIg fusion protein; D016207:Cytokines; D055436:Growth Differentiation Factor 15; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D011993:Recombinant Fusion Proteins; D000072483:Placenta Growth Factor; D002403:Cathepsins; C028217:cathepsin S