title: Usefulness of a combination of monocyte chemoattractant protein-1, galectin-3, and N-terminal probrain natriuretic peptide to predict cardiovascular events in patients with coronary artery disease.
abstract: Patients with coronary artery disease may develop not only ischemic events but also heart failure and death due to previous myocardial damage. The purpose of this study was to test the prognostic value of a panel of plasma biomarkers related to vascular (monocyte chemoattractant protein-1 [MCP-1] and soluble tumor necrosis factor-like weak inducer of apoptosis) and myocardial damage (galectin-3, N-terminal fragment of brain natriuretic peptide [NT-proBNP], and neutrophil gelatinase-associated lipocalin) in 706 patients with chronic coronary artery disease followed for 2.2 ± 0.99 years. Secondary outcomes were the incidence of acute ischemic events (ST elevation myocardial infarction, non-ST elevation acute coronary syndrome, stroke, or transient ischemic attack) and death or heart failure. The primary outcome was the combination of the secondary outcomes. Cox proportional hazards model was used for analysis. Fifty-three patients developed acute ischemic events. Increasing MCP-1 plasma levels (p = 0.002), age, and body mass index predicted this outcome independently. Thirty-three patients developed death and/or heart failure. Galectin-3 (p = 0.007), NT-proBNP plasma levels (p = 0.004), hypertension, glomerular filtration rate, and the use of nitrates and anticoagulants were associated with this outcome independently. The development of the primary outcome was predicted independently by MCP-1 (p <0.001), NT-proBNP (p = 0.005), and galectin-3 (p = 0.019); hypertension; atrial fibrillation; and treatment with nitrates. Every biomarker with a value above the median increased the risk of developing this outcome by 1.832 (95% confidence interval 1.356 to 2.474, p <0.001). High-sensitivity C-reactive protein and lipid levels were not associated with any outcome. In conclusion, increasing MCP-1, galectin-3, and NT-proBNP plasma levels are associated with a greater incidence of cardiovascular events.
authors.affiliation: Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain; Autónoma University, Madrid, Spain; Laboratory of Vascular Pathology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Madrid, Spain. Electronic address: jtunon@secardiologia.es.
authors.forename: José
authors.initials: J
authors.lastname: Tuñón
authors.affiliation: Laboratory of Vascular Pathology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Blanco-Colio
authors.affiliation: Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain; Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Cristóbal
authors.affiliation: Department of Cardiology, Hospital Universitario de Móstoles, Madrid, Spain.
authors.forename: Nieves
authors.initials: N
authors.lastname: Tarín
authors.affiliation: Department of Cardiology, Hospital Clínico Universitario San Carlos, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Higueras
authors.affiliation: Department of Cardiology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Huelmos
authors.affiliation: Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain; Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Alonso
authors.affiliation: Autónoma University, Madrid, Spain; Laboratory of Vascular Pathology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Madrid, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Egido
authors.affiliation: Department of Biochemistry, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Asensio
authors.affiliation: Autónoma University, Madrid, Spain; Laboratory of Vascular Pathology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Lorenzo
authors.affiliation: Department of Preventive Medicine, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mahíllo-Fernández
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Autónoma University, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
authors.affiliation: Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain; Autónoma University, Madrid, Spain.
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Farré
authors.affiliation: Autónoma University, Madrid, Spain; Laboratory of Vascular Pathology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Martín-Ventura
authors.affiliation: Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: López-Bescós
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D018932:Chemokine CCL2 / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications; D018450:Disease Progression; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D037502:Galectin 3 / Q000097:blood*; D006333:Heart Failure / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D015996:Survival Rate / Q000639:trends
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2; D037502:Galectin 3; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain