Key result
A multimarker score in the highest quintile was associated with a significantly higher risk of cardiovascular events compared to the lowest two quintiles in patients with mild to moderate coronary artery lesions (HR 2.77, 95% CI 1.30-5.87, P=0.008).
Why the study?
Does a multimarker score based on inflammatory cytokines improve the prediction of cardiovascular events compared to traditional risk factors in patients with mild to moderate coronary artery lesions?
Cohort (n=964)
Yes
Does a multimarker score based on inflammatory cytokines improve the prediction of cardiovascular events compared to traditional risk factors in patients with mild to moderate coronary artery lesions?
A multimarker approach incorporating inflammatory cytokines improves the prediction of cardiovascular events beyond traditional risk factors in patients with mild to moderate coronary artery lesions.
May stratify risk in mild-moderate lesions; hypothesis-generating for incremental prediction beyond traditional factors.
Few studies have assessed the incremental usefulness of multimarkers as predictors of cardiovascular events in patients with mild to moderate coronary artery lesions.We examined 9 plasma inflammatory cytokines (cathepsin S, CXCL16, sopluble CD40 ligand, interleukin-10, placental growth factor, GDF15, matrix metalloproteinase 9, monocyte chemoattractant protein-1, and high-sensitivity C-reactive protein) in 964 patients showing mild to moderate lesions and assessed their association with risk of cardiovascular events during 3 years of follow-up (median 17 months).In a backward Cox regression procedure, Cystatin S (hazard ratio [HR]: 1.788, 95% CI: 1.233 to 2.593, P = 0.02), soluble CD40 ligand (HR: 1.255, 95% CI: 1.054 to 1.494, P = 0.011), placental growth factor (HR: 1.194, 95% CI: 0.976 to 1.461, P = 0.035), and GDF15 (HR: 0.725, 95% CI: 0.550 to 0.956, P = 0.023) were significantly related to cardiovascular events. Compared with multimarker score (according to regression coefficients of significant biomarkers) in the lowest two quintiles, patients in the highest quintile had a higher risk of cardiovascular events after adjustment for traditional risk factors (HR: 2.77, 95% CI: 1.30 to 5.87, P = 0.008). Adding the multimarker score to traditional risk factors contributed significantly to the prediction of cardiovascular events (AUC increased from 0.67 to 0.72).A multimarker approach added to the predictive information obtained from traditional risk factors in patients with mild to moderate coronary artery lesions.
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Zhang et al. (2012) conducted a cohort in Mild to moderate coronary artery lesions (n=964). High multimarker score (Cystatin S, SCD40L, PlGF, GDF15) vs. Low multimarker score (lowest two quintiles) was evaluated on Cardiovascular events (cardiac death, nonfatal myocardial infarction, target lesion revascularization, and angina pectoris requiring rehospitalization) (HR 2.77, 95% CI 1.30-5.87, p=0.008). A multimarker score in the highest quintile was associated with a significantly higher risk of cardiovascular events compared to the lowest two quintiles in patients with mild to moderate coronary artery lesions (HR 2.77, 95% CI 1.30-5.87, P=0.008).
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