title: Elevated glycated albumin and reduced endogenous secretory receptor for advanced glycation endproducts levels in serum predict major adverse cardio-cerebral events in patients with type 2 diabetes and stable coronary artery disease.
abstract: OBJECTIVE
  Glycated albumin (GA) and the endogenous secretory receptor for advanced glycation endproducts (esRAGE) may modulate risk related to atherosclerosis. We tested the hypothesis that elevated GA and reduced esRAGE in serum are associated with adverse clinical outcomes in patients with type 2 diabetes and stable coronary artery disease (CAD).
  
  
  METHODS
  We determined GA and esRAGE serum levels in 576 consecutive patients with type 2 diabetes and stable CAD undergoing sirolimus-eluting stent (SES)-PCI. The primary endpoint was the incidence of major adverse cardio-cerebral events (MACCE) including cardiac death, non-fatal myocardial infarction, and non-fatal stroke during a 2-year follow-up. The secondary endpoint was the occurrence of clinically driven repeat revascularization during a 2-year follow-up. The prognostic value of GA and esRAGE was determined with the Cox-proportional hazard model after adjustment for covariates.
  
  
  RESULTS
  A total 40 patients (6.9%) experienced MACCE, and 108 (18.8%) patients underwent repeat coronary revascularization during the follow-up. Serum GA (HR=1.22, 95% CI 1.16-1.28; HR=1.15, 95% CI 1.11-1.19, respectively; for both p<0.001) and esRAGE (HR=0.60, 95% CI 0.40-0.87; HR=0.75, 95% CI 0.61-0.92, respectively; for both p<0.01) levels remained independent predictors of the primary and secondary endpoints after adjustment for possible confounders.
  
  
  CONCLUSIONS
  Serum GA and esRAGE are novel predictors of long-term clinical outcomes in patients with type 2 diabetes and stable CAD. Increased serum GA and decreased esRAGE are associated with a poor prognosis in such patients.
authors.affiliation: Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China.
authors.forename: Zhen Kun
authors.initials: ZK
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China; Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China.
authors.forename: Wei Feng
authors.initials: WF
authors.lastname: Shen
authors.affiliation: Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China.
authors.forename: Li Jin
authors.initials: LJ
authors.lastname: Pu
authors.affiliation: Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China.
authors.forename: Hua
authors.initials: H
authors.lastname: Meng
authors.affiliation: Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China.
authors.forename: Rui Yan
authors.initials: RY
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China.
authors.forename: Qiu Jing
authors.initials: QJ
authors.lastname: Chen
authors.affiliation: "G. d'Annunzio University", Chieti, Italy; Fondazione "G. Monasterio", Pisa, Italy. Electronic address: rdecater@unich.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Caterina
authors.affiliation: Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China; Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China. Electronic address: lulin1965@yahoo.com.cn.
authors.forename: Lin
authors.initials: L
authors.lastname: Lu
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D017127:Glycation End Products, Advanced / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000401:mortality / Q000639:trends; D011237:Predictive Value of Tests; D000067759:Receptor for Advanced Glycation End Products / Q000097:blood*; D012709:Serum Albumin / Q000378:metabolism*; D015996:Survival Rate / Q000639:trends; D000093423:Glycated Serum Albumin
chemical_list: C000593871:AGER protein, human; D015415:Biomarkers; D017127:Glycation End Products, Advanced; D000067759:Receptor for Advanced Glycation End Products; D012709:Serum Albumin; D000093423:Glycated Serum Albumin
keywords: Coronary heart disease; Diabetes mellitus; Endogenous secretory RAGE; Glycated albumin; Percutaneous coronary intervention; Prognosis