title: [Impact of plasma pro-B-type natriuretic peptide amino-terminal and galectin-3 levels on the predictive capacity of the LIPID Clinical Risk Scale in stable coronary disease].
abstract: BACKGROUND
  At present, there is no tool validated by scientific societies for risk stratification of patients with stable coronary artery disease (SCAD). It has been shown that plasma levels of monocyte chemoattractant protein-1 (MCP-1), galectin-3 and pro-B-type natriuretic peptide amino-terminal (NT-proBNP) have prognostic value in this population.
  
  
  OBJECTIVE
  To analyze the prognostic value of a clinical risk scale published in Long-term Intervention with Pravastatin in Ischemic Disease (LIPID) study and determining its predictive capacity when combined with plasma levels of MCP-1, galectin-3 and NT-proBNP in patients with SCAD.
  
  
  RESULTS
  A total of 706 patients with SCAD and a history of acute coronary syndrome (ACS) were analyzed over a follow up period of 2.2 ± 0.99 years. The primary endpoint was the occurrence of an ischemic event (any SCA, stroke or transient ischemic attack), heart failure, or death. A clinical risk scale derived from the LIPID study significantly predicted the development of the primary endpoint, with an area under the ROC curve (Receiver Operating Characteristic) of 0.642 (0.579 to 0.705); P<0.001. A composite score was developed by adding the scores of the LIPID and scale decile levels of MCP -1, galectin -3 and NT-proBNP. The predictive value improved with an area under the curve of 0.744 (0.684 to 0.805); P<0.001 (P=0.022 for comparison). A score greater than 21.5 had a sensitivity of 74% and a specificity of 61% for the development of the primary endpoint (P<0.001, log -rank test).
  
  
  CONCLUSIONS
  Plasma levels of MCP-1, galectin -3 and NT-proBNP improve the ability of the LIPID clinical scale to predict the prognosis of patients with SCAD.
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario San Carlos, Madrid, España; Universidad Complutense, Madrid, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Higueras
authors.affiliation: Universidad Autónoma, Madrid, España; Laboratorio de Patología Vascular, IIS-Fundación Jiménez Díaz, Madrid, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Martín-Ventura
authors.affiliation: Laboratorio de Patología Vascular, IIS-Fundación Jiménez Díaz, Madrid, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Blanco-Colio
authors.affiliation: Servicio de Cardiología, Hospital de Fuenlabrada, Fuenlabrada, Madrid, España; Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Cristóbal
authors.affiliation: Servicio de Cardiología, Hospital Universitario de Móstoles, Móstoles, Madrid, España.
authors.forename: Nieves
authors.initials: N
authors.lastname: Tarín
authors.affiliation: Servicio de Cardiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Huelmos
authors.affiliation: Servicio de Cardiología, Hospital de Fuenlabrada, Fuenlabrada, Madrid, España; Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Alonso
authors.affiliation: Servicio de Cardiología, IIS-Fundación Jiménez Díaz, Madrid, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Pello
authors.affiliation: Servicio de Cardiología, IIS-Fundación Jiménez Díaz, Madrid, España.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Aceña
authors.affiliation: Servicio de Cardiología, IIS-Fundación Jiménez Díaz, Madrid, España.
authors.forename: Rocío
authors.initials: R
authors.lastname: Carda
authors.affiliation: Universidad Autónoma, Madrid, España; Laboratorio de Patología Vascular, IIS-Fundación Jiménez Díaz, Madrid, España.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Lorenzo
authors.affiliation: Servicio de Medicina Preventiva, IIS-Fundación Jiménez Díaz, Madrid, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mahíllo-Fernández
authors.affiliation: Laboratorio de bioquímica de la Fundación Jiménez Díaz, Madrid, España.
authors.forename: Dolores
authors.initials: D
authors.lastname: Asensio
authors.affiliation: Servicio de Cardiología, IIS-Fundación Jiménez Díaz, Madrid, España.
authors.forename: Pedro
authors.initials: P
authors.lastname: Almeida
authors.affiliation: Servicio de Medicina Preventiva y Salud Pública, Escuela de Medicina, Universidad Autónoma, Madrid, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
authors.affiliation: Universidad Autónoma, Madrid, España; Servicio de Cardiología, IIS-Fundación Jiménez Díaz, Madrid, España.
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Farré
authors.affiliation: Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: López Bescós
authors.affiliation: Universidad Autónoma, Madrid, España; Laboratorio de Patología Vascular, IIS-Fundación Jiménez Díaz, Madrid, España; CIBERDEM, Madrid, España.
authors.forename: Jesús
authors.initials: J
authors.lastname: Egido
authors.affiliation: Universidad Autónoma, Madrid, España; Laboratorio de Patología Vascular, IIS-Fundación Jiménez Díaz, Madrid, España; Servicio de Cardiología, IIS-Fundación Jiménez Díaz, Madrid, España. Electronic address: jtunon@secardiologia.es.
authors.forename: José
authors.initials: J
authors.lastname: Tuñón
mesh_terms: D000368:Aged; D018932:Chemokine CCL2 / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D037502:Galectin 3 / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D017035:Pravastatin / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D037502:Galectin 3; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D017035:Pravastatin
keywords: Enfermedad coronaria estable; Galectina-3; Galectine-3; NT-proBNP; Pro-péptido natriurético tipo B aminoterminal; Stable coronary artery disease