Soluble receptors for advanced glycation end products is associated with cardiac mortality among patients with stable ischemic heart disease: long-term follow-up of the LAERTES study

It has been suggested that circulating levels of the soluble receptor for advanced glycation end products (sRAGE) is a biomarker of underlying inflammation. There is limited data regarding its prognostic value in patients with stable coronary artery disease (CAD). We explored the long-term prognostic value of sRAGE levels on cardiac mortality in patients with CAD. This is a retrospective analysis from LAERTES Study. Serum sRAGE levels were measured at baseline. sRAGE were quantified using DuoSetELISA kit. Primary endpoint was cardiac death and secondary endpoint the composite of non-fatal acute coronary syndrome (ACS) and ischemic stroke. Data were obtained from 800 patients (13% female, median age 62 years, median follow-up 6 years) of whom 76 died from cardiac death, 84 experienced ACS and 12 had ischemic stroke. Patients with cardiac death were older and had more comorbidities. sRAGE levels were predictive of cardiac death and remained an independent predictor for cardiac death (HR: 1.31, 95% CI: 1.03-1.67, p = 0.027) after adjustment for traditional risk factors and left ventricular ejection fraction. sRAGE levels could not predict the secondary endpoints. Higher sRAGE levels are independently associated with cardiac mortality among CAD patients. Patients with CAD, even at stable stage, are still threatened by higher mortality, thus risk prediction is particularly important. Inflammation plays a central role in the development and progression of atherosclerosis, contributing to both the initiation and destabilization of atherosclerotic plaques. It has been suggested that circulating sRAGE levels reflect chronic low-grade inflammation and further research is warranted to fully clarify the complex biological mechanisms of the RAGE axis in atherosclerosis.