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Serum-amyloid-A/LDL complex and NT-proBNP independently correlated with severe angiographic coronary artery disease in patients with suspected, but no history of coronary heart disease: the ANOX study

Session Poster session 1

Speaker Hiromichi Wada

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : H Wada (Kyoto,JP), M Suzuki (Saitama,JP), M Matsuda (Kure,JP), Y Ajiro (Yokohama,JP), T Shinozaki (Sendai,JP), S Sakagami (Kanazawa,JP), K Yonezawa (Hakodate,JP), M Shimizu (Kobe,JP), J Funada (Toon,JP), T Takenaka (Sapporo,JP), Y Morita (Sagamihara,JP), K Kotani (Shimotsuke,JP), M Abe (Kyoto,JP), M Akao (Kyoto,JP), K Hasegawa (Kyoto,JP)

Authors:
H. Wada1 , M. Suzuki2 , M. Matsuda3 , Y. Ajiro4 , T. Shinozaki5 , S. Sakagami6 , K. Yonezawa7 , M. Shimizu8 , J. Funada9 , T. Takenaka10 , Y. Morita11 , K. Kotani12 , M. Abe1 , M. Akao1 , K. Hasegawa1 , 1National Hospital Organization Kyoto Medical Center - Kyoto - Japan , 2National Hospital Organization Saitama National Hospital - Saitama - Japan , 3National Hospital Organization Kure Medical Center - Kure - Japan , 4National Hospital Organization Yokohama Medical Center - Yokohama - Japan , 5National Hospital Organization Sendai Medical Center - Sendai - Japan , 6National Hospital Organization Kanazawa Medical Center - Kanazawa - Japan , 7National Hospital Organization Hakodate National Hospital - Hakodate - Japan , 8National Hospital Organization Kobe Medical Center - Kobe - Japan , 9National Hospital Organization Ehime Medical Center - Toon - Japan , 10National Hospital Organization Hokkaido Medical Center - Sapporo - Japan , 11National Hospital Organization Sagamihara National Hospital - Sagamihara - Japan , 12Jichi Medical University - Shimotsuke - Japan ,

On behalf: the ANOX study investigators

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 187

Background: Biomarkers predicting the severity of coronary artery disease (CAD) in patients with suspected, but no history of CAD are not fully established.

Methods: The ANOX study is a multicenter, prospective cohort study to determine the predictive value of possible novel biomarkers related to angiogenesis or oxidative stress for major adverse cardiovascular events among patients undergoing elective angiography. Between January 2010 and November 2013, a total of 2,513 patients were enrolled. After excluding 93 patients who were subsequently found ineligible or withdrew consent, and 702 patients with a history of myocardial infarction or coronary revascularization, the baseline data of 1,718 patients (49% with CAD, 26% with multi-vessel disease [MVD]) were analyzed. Blood samples were collected from the arterial catheter sheath at the beginning of coronary angiography. The presence of angiographic CAD (≥50% stenosis in ≥1 coronary artery) and its severity were assessed using the Gensini score. Serum levels of vascular endothelial growth factor (VEGF), VEGF-C, soluble VEGF receptor-2 (sVEGFR-2), and two oxidatively modified LDLs (α1-antitrypsin/LDL and serum-amyloid-A/LDL [SAA-LDL]), as well as N-terminal pro-brain natriuretic peptide, high-sensitivity troponin-I (hsTrop-I), and high-sensitivity C-reactive protein, were measured. We performed stepwise regression analyses including data on age, sex, the body mass index, systolic blood pressure (SBP), LDL- cholesterol, HDL- cholesterol (HDL-C), diabetes, history of smoking habit, estimated glomerular filtration rate, antihypertensive drug use, statin use, oral hypoglycemic drug use, insulin use, antiplatelet drug use, and these biomarkers.

Results: The presence of CAD was significantly correlated with age, a male sex, SBP, HDL-C, diabetes, statin use, antiplatelet drug use, and natural log-transformed hsTrop-I (Ln-hsTrop-I) (OR, 1.6 per 1-SD increase; 95% CI, 1.2–2.2). In contrast, the presence of MVD was significantly correlated with Ln-SAA-LDL (OR, 1.2 per 1-SD increase; 95% CI, 1.1–1.4) and Ln-NT-proBNP (OR, 1.3 per 1-SD increase; 95% CI, 1.1–1.4), as well as a male sex, HDL-C, diabetes, statin use, and antiplatelet drug use. After excluding 476 patients with a Gensini score of 0 to obtain a normal distribution, independent determinants of the Ln-Gensini score were diabetes, HDL-C, antiplatelet drug use, Ln-Trop-I, Ln-NT-proBNP, and Ln-SAA-LDL.

Conclusions: Serum levels of SAA-LDL and NT-proBNP were independently correlated with severe angiographic CAD, while those of hsTrop-I were independently correlated with the presence of CAD, in patients with suspected, but no history of CAD.

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