title: Differential profile in inflammatory and mineral metabolism biomarkers in patients with ischemic heart disease without classical coronary risk factors.
abstract: BACKGROUND
  Patients with coronary heart disease (CHD) without classical cardiovascular risk factors (CRFs) are uncommon, and their profile has not been thoroughly studied. In CHD patients, we have assessed the differences in several biomarkers between those with and without CRF.
  
  
  METHODS
  We studied 704 patients with CHD, analyzing plasma levels of biomarkers related to inflammation, thrombosis, renal damage, and heart failure: high-sensitivity C-reactive protein (hs-CRP), monocyte chemoattractant protein-1 (MCP-1), galectin-3, N-terminal fragment of brain natriuretic peptide (NT-pro-BNP), calcidiol (vitamin D metabolite), fibroblast growth factor-23 (FGF-23), parathormone, and phosphate.
  
  
  RESULTS
  Twenty patients (2.8%) exhibited no CRFs. Clinical variables were well balanced in both groups, with the logical exceptions of no use of antidiabetic drugs, lower triglyceride and glucose, and higher high-density lipoprotein cholesterol in no-CRF patients. No-CRF patients showed lower hs-CRP (2.574±3.120 vs. 4.554±9.786mg/L; p=0.018), MCP-1 (114.75±36.29 vs. 143.56±65.37pg/ml; p=0.003), and FGF-23 (79.28±40.22 vs. 105.17±156.61RU/ml; p=0.024), and higher calcidiol (23.66±9.12 vs. 19.49±8.18ng/ml; p=0.025) levels. At follow-up, 10.0% vs. 11.0% patients experienced acute ischemic event, heart failure, or death in the non-CRF and CRF groups, respectively (p=0.815, log-rank test). The limited number of non-CRF patients may have influenced this finding. A Cox regression analysis in the whole population showed that high calcidiol, and low MCP-1 and FGF-23 plasma levels are associated with a better prognosis.
  
  
  CONCLUSIONS
  CHD patients without CRFs show a favorable biomarker profile in terms of inflammation and mineral metabolism. Further studies are needed to investigate whether this difference translates into a better prognosis.
authors.affiliation: Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Pello
authors.affiliation: Department of Cardiology, Hospital de Fuenlabrada, Fuenlabrada, Spain; Rey Juan Carlos University, Alcorcón, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Cristóbal
authors.affiliation: Department of Cardiology, Hospital Universitario de Móstoles, Móstoles, Spain.
authors.forename: Nieves
authors.initials: N
authors.lastname: Tarín
authors.affiliation: Department of Cardiology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Huelmos
authors.affiliation: Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Aceña
authors.affiliation: Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: Carda
authors.affiliation: Laboratory of Nephrology and Mineral Metabolism, Hospital Gómez-Ulla, Madrid, Spain.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: González-Casaus
authors.affiliation: Department of Cardiology, Hospital de Fuenlabrada, Fuenlabrada, Spain; Rey Juan Carlos University, Alcorcón, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Alonso
authors.affiliation: Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz, Madrid, Spain; Autónoma University, Madrid, Spain.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Lorenzo
authors.affiliation: Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Blanco-Colio
authors.affiliation: Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz, Madrid, Spain; Autónoma University, Madrid, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Martín-Ventura
authors.affiliation: Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Franco Peláez
authors.affiliation: Department of Epidemiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mahíllo-Fernández
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: Rey Juan Carlos University, Alcorcón, Spain.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: López-Bescós
authors.affiliation: Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz, Madrid, Spain; Autónoma University, Madrid, Spain; Department of Nephrology, IIS-Fundación Jiménez Díaz, Madrid, Spain; CIBERDEM, Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Egido
authors.affiliation: Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain; Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz, Madrid, Spain; Autónoma University, Madrid, Spain. Electronic address: jtunon@secardiologia.es.
authors.forename: José
authors.initials: J
authors.lastname: Tuñón
mesh_terms: D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002112:Calcifediol / Q000097:blood; D018932:Chemokine CCL2 / Q000097:blood; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D037502:Galectin 3 / Q000097:blood; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000209:etiology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010710:Phosphates / Q000097:blood; D011379:Prognosis; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; C000717427:FGF23 protein, human; D037502:Galectin 3; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D010281:Parathyroid Hormone; D010446:Peptide Fragments; D010710:Phosphates; D014280:Triglycerides; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D002097:C-Reactive Protein; D002784:Cholesterol; D002112:Calcifediol
keywords: Atherosclerosis; Biomarkers; Cardiovascular risk factors; Fibroblast growth factor-23; Monocyte chemoattractant protein-1