title: Copper, ceruloplasmin, and long-term cardiovascular and total mortality (the Ludwigshafen Risk and Cardiovascular Health Study).
abstract: BACKGROUND
  Copper and its main transport protein ceruloplasmin have been suggested to promote the development of atherosclerosis. Most of the data come from experimental and animal model studies. Copper and mortality have not been simultaneously evaluated in patients undergoing coronary angiography.
  
  
  RESULTS
  We examined whether serum copper and ceruloplasmin concentrations are associated with angiographic coronary artery disease (CAD) and mortality from all causes and cardiovascular causes in 3253 participants of the Ludwigshafen Risk and Cardiovascular Health Study. Age and sex-adjusted hazard ratios (HR) for death from any cause were 2.23 (95% CI, 1.85-2.68) for copper and 2.63 (95% CI, 2.17-3.20) for ceruloplasmin when we compared the highest with the lowest quartiles. Corresponding hazard ratios (HR) for death from cardiovascular causes were 2.58 (95% CI, 2.05-3.25) and 3.02 (95% CI, 2.36-3.86), respectively. Further adjustments for various risk factors and clinical variables considerably attenuated these associations, which, however, were still statistically significant and the results remained consistent across subgroups.
  
  
  CONCLUSIONS
  The elevated concentrations of both copper and ceruloplasmin are independently associated with increased risk of mortality from all causes and from cardiovascular causes.
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg , Mannheim , Germany.
authors.forename: T B
authors.initials: TB
authors.lastname: Grammer
authors.forename: M E
authors.initials: ME
authors.lastname: Kleber
authors.forename: G
authors.initials: G
authors.lastname: Silbernagel
authors.forename: S
authors.initials: S
authors.lastname: Pilz
authors.forename: H
authors.initials: H
authors.lastname: Scharnagl
authors.forename: E
authors.initials: E
authors.lastname: Lerchbaum
authors.forename: A
authors.initials: A
authors.lastname: Tomaschitz
authors.forename: W
authors.initials: W
authors.lastname: Koenig
authors.forename: W
authors.initials: W
authors.lastname: März
mesh_terms: D002570:Ceruloplasmin / Q000032:analysis*; D003300:Copper / Q000097:blood*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000401:mortality* / Q000473:pathology; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000401:mortality / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D012307:Risk Factors
chemical_list: D003300:Copper; D002570:Ceruloplasmin