Prognostic Impacts of Plasma Levels of Cyclophilin A in Patients With Coronary Artery Disease.
Cyclophilin A (CyPA) is secreted from vascular smooth muscle cells, inflammatory cells, and activated platelets in response to oxidative stress. We have recently demonstrated that plasma CyPA level is a novel biomarker for diagnosing coronary artery disease. However, it remains to be elucidated whether plasma CyPA levels also have a prognostic impact in such patients.



In 511 consecutive patients undergoing diagnostic coronary angiography, we measured the plasma levels of CyPA, high-sensitivity C-reactive protein (hsCRP), and brain natriuretic peptide and evaluated their prognostic impacts during the follow-up (42 months, interquartile range: 25-55 months). Higher CyPA levels (≥12 ng/mL) were significantly associated with all-cause death, rehospitalization, and coronary revascularization. Higher hsCRP levels (≥1 mg/L) were also significantly correlated with the primary end point and all-cause death, but not with rehospitalization or coronary revascularization. Similarly, higher brain natriuretic peptide levels (≥100 pg/mL) were significantly associated with all-cause death and rehospitalization, but not with coronary revascularization. Importantly, the combination of CyPA (≥12 ng/mL) and hsCRP (≥1 mg/L) was more significantly associated with all-cause death (hazard ratio, 21.2; 95% confidence interval, 4.9-92.3,;P<0.001) than CyPA (≥12 ng/mL) or hsCRP (≥1 mg/L) alone.



The results indicate that plasma CyPA levels can be used to predict all-cause death, rehospitalization, and coronary revascularization in patients with coronary artery disease and that when combined with other biomarkers (hsCRP and brain natriuretic peptide levels), the CyPA levels have further enhanced prognostic impacts in those patients.
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Tomohiro
T
Ohtsuki
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kimio
K
Satoh
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Junichi
J
Omura
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Nobuhiro
N
Kikuchi
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Taijyu
T
Satoh
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Ryo
R
Kurosawa
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Masamichi
M
Nogi
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Shinichiro
S
Sunamura
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Nobuhiro
N
Yaoita
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Tatsuo
T
Aoki
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Shunsuke
S
Tatebe
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Koichiro
K
Sugimura
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Jun
J
Takahashi
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Satoshi
S
Miyata
From the Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan. shimo@cardio.med.tohoku.ac.jp.
Hiroaki
H
Shimokawa
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002423:Cause of Death; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D021984:Cyclophilin A / Q000097:blood*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010359:Patient Readmission; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D019233:Retreatment; D012307:Risk Factors; D013997:Time Factors
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D021984:Cyclophilin A
atherosclerosis; biomarker; coronary artery disease; natriuretic peptide, brain; prognosis