Acute-Phase Plasma PCSK9 Levels and Recurrent Cardiovascular Events in a Chinese Acute Myocardial Infarction Cohort

Cardiology ◽  
2018 ◽  
Vol 141 (2) ◽  
pp. 88-97 ◽  
Author(s):  
Yan Gao ◽  
Yan Qiu ◽  
Jihua Wu ◽  
Wei Diao ◽  
Haibo Zhang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Phase ◽  
Recurrent Events ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Female Gender ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk

Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising target for lowering plasma low-density lipoprotein cholesterol and preventing cardiovascular (CV) disease. Whether plasma PCSK9 measured during the acute phase predicts recurrent CV events in patients with acute myocardial infarction (AMI) remains unresolved. Methods and Results: Plasma PCSK9 levels were measured in 1,646 patients with AMI from the China PEACE-Prospective AMI Study at the acute phase. Additionally, 248 patients were resampled and measured at 1 month post-AMI. Associations of acute-phase PCSK9 tertiles with clinical characteristics and recurrent CV events within 1 year were assessed. Female gender (OR 1.94, 95% CI 1.24–3.03), premature coronary heart disease (CHD; OR 2.12, 95% CI 1.37–3.26), higher high-sensitivity C-reactive protein (OR 1.67, 95% CI 1.44–1.95), and higher triglycerides (OR 1.46, 95% CI 1.03–2.09) were associated with higher baseline PCSK9. Plasma PCSK9 levels in the highest tertile (versus lowest) did not have an increased risk of 1-year recurrent CV events in the AMI cohort (HR 0.78, 95% CI 0.52–1.16) or any subgroup. There was also no association between percentage changes in PCSK9 over the first month and 1-year recurrent events, although there was a trend of differences between patients in the upper versus lower tertiles. Conclusion: Plasma PCSK9 levels measured during the acute phase were associated with high-sensitivity C-reactive protein, triglycerides, premature CHD, and gender in patients with AMI but did not predict recurrent CV events within 1 year. Dynamic changes in PCSK9 suggested a trend yet no significance value in predicting recurrent CV events.

Abstract 3532: Lipoprotein-Associated Phospholipase A 2 and High Sensitivity C-Reactive Protein Levels and the Prediction of Cardiovascular Risk Among Coronary Artery Disease Patients With Differing Clinical Presentations

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Heidi T May ◽  
Jeffrey L Anderson ◽  
Benjamin D Horne ◽  
Robert R Pearson ◽  
Robert L Wolfert ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
High Sensitivity ◽  
Phospholipase A ◽  
Specific Marker ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Artery Disease

Background : Inflammation plays a role in the development and progression of coronary artery disease (CAD), with circulating markers of vascular inflammation being used in risk assessment including high sensitivity C-reactive protein (hsCRP) and lipoprotein-associated phospholipase A 2 (LpPLA 2 ). While hsCRP responds to the systemic inflammatory stimulus of acute myocardial infarction (AMI), LpPLA 2 has been proposed to be more vascular-specific and to vary minimally based upon clinical presentation. To test this hypothesis, we evaluated both biomarkers among CAD patients presenting with stable angina (SA), unstable angina (USA) or acute myocardial infarction (AMI). Methods : LpPLA 2 (PLAC TM test, diaDexus, Inc.) and hsCRP were measured from samples donated by consenting patients (N=1,010) enrolled in the registry of the Intermountain Heart Collaborative Study that underwent angiographic evaluation for CAD. Patients were categorized by presentation status (SA=637; USA=205; and AMI=168), stratified according to median levels of LpPLA 2 (350.2 ng/mL) and hsCRP above and below 3 mgl/L and followed for 7.5 ± 2.4 years for CAD death. Results : Age averaged 64 ± 12 years and 70% were male. While median hsCRP (mg/L) levels differed significantly by presentation [2.86, 2.80, and 13.7 for SA, USA, and AMI, respectively (p<0.0001)], median LpPLA 2 (ng/mL) levels [350.2, 353.1, and 348.1 for SA, USA, and AMI, respectively (p=0.67)], did not. LpPLA 2 was not only a better predictor of CAD death among the entire cohort (LpPLA 2 : adjusted Hazard Ratio [HR]= 1.47, p=0.04; hsCRP: adjusted HR=0.95, p=0.81), it was a better predictor among patients presenting with AMI (LpPLA 2 : adjusted HR3 1.80, p=0.30; hsCRP adjusted HR=0.76, p=0.63). Conclusions : Among CAD patients, LpPLA 2 varies minimally among differing presentations compared to hsCRP and is a better a predictor of CAD death among those presenting with AMI. This information supports the hypothesis that LpPLA 2 is a vascular specific marker of inflammation and independent of transient systemic inflammatory effects.

scholarly journals Concomitant Impact of High-Sensitivity C-Reactive Protein and Renal Dysfunction in Patients with Acute Myocardial Infarction

2014 ◽  
Vol 55 (1) ◽  
pp. 132 ◽  
Author(s):  
Yong Un Kang ◽  
Min Jee Kim ◽  
Joon Seok Choi ◽  
Chang Seong Kim ◽  
Eun Hui Bae ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Renal Dysfunction ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study

2019 ◽  
Vol 8 (12) ◽  
pp. 2192 ◽  
Author(s):  
Nicola Cosentino ◽  
Stefano Genovese ◽  
Jeness Campodonico ◽  
Alice Bonomi ◽  
Claudia Lucci ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
High Sensitivity ◽  
Future Research ◽  
Hospital Death ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hs Crp

Background. Accumulating evidence suggests that inflammation plays a key role in acute kidney injury (AKI) pathogenesis. We explored the relationship between high-sensitivity C-reactive protein (hs-CRP) and AKI in acute myocardial infarction (AMI). Methods. We prospectively included 2,063 AMI patients in whom hs-CRP was measured at admission. AKI incidence and a clinical composite of in-hospital death, cardiogenic shock, and acute pulmonary edema were the study endpoints. Results. Two-hundred-thirty-four (11%) patients developed AKI. hs-CRP levels were higher in AKI patients (45 ± 87 vs. 16 ± 41 mg/L; p < 0.0001). The incidence and severity of AKI, as well as the rate of the composite endpoint, increased in parallel with hs-CRP quartiles (p for trend <0.0001 for all comparisons). A significant correlation was found between hs-CRP and the maximal increase of serum creatinine (R = 0.23; p < 0.0001). The AUC of hs-CRP for AKI prediction was 0.69 (p < 0.001). At reclassification analysis, addition of hs-CRP allowed to properly reclassify 14% of patients when added to creatinine and 8% of patients when added to a clinical model. Conclusions. In AMI, admission hs-CRP is closely associated with AKI development and severity, and with in-hospital outcomes. Future research should focus on whether prophylactic renal strategies in patients with high hs-CRP might prevent AKI and improve outcome.

scholarly journals HIGH-SENSITIVITY C-REACTIVE PROTEIN AND ACUTE KIDNEY INJURY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

2020 ◽  
Vol 75 (11) ◽  
pp. 163
Author(s):  
Giancarlo Silvio Marenzi ◽  
Jeness Campodonico ◽  
Nicola Cosentino ◽  
Claudia Lucci ◽  
Valentina Milazzo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Prognostic Value of High-Sensitivity C-Reactive Protein and Lipoprotein (a) in Acute Myocardial Infarction Patients Receiving Emergency Percutaneous Coronary Intervention

2012 ◽  
Vol 31 (2) ◽  
pp. 131-134
Author(s):  
Shifang Ding ◽  
Yi Peng ◽  
Zhinan Chen ◽  
Juquan Jiang ◽  
Zhigang Gong ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
High Sensitivity ◽  
Coronary Intervention ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Percutaneous Coronary ◽  
Emergency Percutaneous Coronary Intervention

Prognostic Value of High-Sensitivity C-Reactive Protein and Lipoprotein (a) in Acute Myocardial Infarction Patients Receiving Emergency Percutaneous Coronary InterventionIn order to study the prognostic value of high-sensitivity C-reactive protein (hsCRP) and lipoprotein (a) [Lp(a)] in patients receiving emergency percutaneous coronary intervention (PCI) following acute myocardial infarction (AMI), we retrospectively reviewed 118 patients who received emergency PCI following AMI from January 2007 to April 2010. The plasma levels of hsCRP and Lp(a) were determined. The incidence of cardiovascular events was compared between patients with an elevated hsCRP level and those with a normal hsCRP level and between patients with an elevated Lp(a) level and those with a normal Lp(a) level. Results showed that the incidence of cardiovascular events was 52.9% in the hsCRP-elevated group and 18.2% in the hsCRP-normal group displaying a significant difference (P=0.011). However, the incidence of cardiovascular events was 35.3% in the Lp(a)-elevated group and 46.4% in the Lp(a)-normal group and statistical analysis revealed no significant difference (P=0.733). HsCRP, but not Lp(a), can serve as a prognostic factor for patients receiving emergency PCI following AMI.

scholarly journals The High-Sensitivity C-Reactive Protein to Prealbumin Ratio Predicts Adverse Cardiovascular Events after ST-Elevation Myocardial Infarction

2021 ◽  
Vol 24 (1) ◽  
pp. E153-E157
Author(s):  
Hongqiang Ren ◽  
Li Zhao ◽  
Yijun Liu ◽  
Zhen Tan ◽  
Guiquan Luo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Roc Curve ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
High Sensitivity ◽  
St Elevation Myocardial Infarction ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk ◽  
St Elevation

Background: This study evaluated the association of the high-sensitivity C-reactive protein to prealbumin ratio (CPR) with adverse cardiovascular events after ST-elevation myocardial infarction (STEMI) in patients undergoing primary percutaneous coronary intervention (PCI). Methods: The study included 682 patients who presented with STEMI and were treated with primary PCI. Patients were divided into 2 groups: high CPR (CPR ≥0.02) and low CPR (CPR <0.02). The primary endpoint of the study was the occurrence of major adverse cardiovascular events (MACE), defined as cardiovascular mortality or admission due to recurrent AMI or heart failure. Multivariate Cox regression models were used to assess the prognostic value of CPR on MACE in patients with STEMI. Results: During a median follow-up of 18 months, the accumulated incidence rate of MACE was significantly higher in the high-CPR group than in the low-CPR group (38.7% versus 12.0%, P < .01). Multivariate analysis revealed that CPR was an independent predictor for increased risk of MACE (hazard ratio = 3.27, 95% confidence interval [CI] 2.14 to 4.49, P < .01). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve for predicting the diagnosis of MACE was higher for CPR (0.82, 95% CI 0.77 to 0.87) than hs-CRP (0.70, 95% CI 0.65 to 0.75). Conclusion: CPR was independently associated with MACE and can be used for risk stratification in patients with STEMI.

Sign in / Sign up

Export Citation Format

Share Document