Coronary Artery Disease and Type 2 Diabetes: A Proteomic Study

Abstract

Coronary artery disease (CAD) is a major challenge in patients with type 2 diabetes (T2D). Coronary computed tomography angiography (CCTA) provides a detailed anatomic map of the coronary circulation. Proteomics are increasingly used to improve diagnostic and therapeutic algorithms. We hypothesized that the protein panel is differentially associated with T2D and CAD. RESEARCH DESIGN AND METHODSIn CAPIRE (Coronary Atherosclerosis in Outlier Subjects: Protective and Novel Individual Risk Factors Evaluationda cohort of 528 individuals with no previous cardiovascular event undergoing CCTA), participants were grouped into CAD 2 (clean coronaries) and CAD 1 (diffuse lumen narrowing or plaques). Plasma proteins were screened by aptamer analysis. Two-way partial least squares was used to simultaneously rank proteins by diabetes status and CAD. RESULTSThough CAD 1 was more prevalent among participants with T2D (HbA 1c 6.7 6 1.1%) than those without diabetes (56 vs. 30%, P < 0.0001), CCTA-based atherosclerosis burden did not differ. Of the 20 top-ranking proteins, 15 were associated with both T2D and CAD, and 3 (osteomodulin, cartilage intermediate-layer protein 2, and HTRA1) were selectively associated with T2D only and 2 (epidermal growth factor receptor and contactin-1) with CAD only. Elevated renin and GDF15, and lower adiponectin, were independently associated with both T2D and CAD. In multivariate analysis adjusting for the Framingham risk panel, patients with T2D were "protected" from CAD if female (P 5 0.007), younger (P 5 0.021), and with lower renin levels (P 5 0.02). CONCLUSIONSWe concluded that 1) CAD severity and quality do not differ between participants with T2D and without diabetes; 2) renin, GDF15, and adiponectin are shared markers by T2D and CAD; 3) several proteins are specifically associated with T2D or CAD; and 4) in T2D, lower renin levels may protect against CAD.Cardiovascular (CV) disease has steadily represented the leading cause of death in the world for the past 15 years, with coronary artery disease (CAD) and stroke being responsible for a combined 15 million deaths in 2016 (1). Morbidity and mortality of patients with CAD is considerably higher in the presence of diabetes, accounting for ;50% of deaths in this population (2). Therefore, detection of CAD and its risk factors

Proteomic Studies of Blood and Vascular Wall in Atherosclerosis

“…And increased concentrations of renin and growth differentiation factor 15 (GDF15) proteins and a lower adiponectin level were independently associated with coronary heart disease and diabetes mellitus [31]. In a proteomic study of Monu with co-authors, differences in 19 proteins were identified in the blood of patients with coronary heart disease compared to healthy ones.…”

Precision Phenomapping of Acute Coronary Syndromes to Improve Patient Outcomes

“…The use of omic disciplines-globally referred to as panomic or multi-omic technologies-to support decisional processes may represent a daunting perspective for clinicians dealing with ischaemic heart diseases. Only recently have paradigms begun to shift, with big data collection starting to offer omic information to practicing cardiologists [17][18][19]. On the other hand, oncology, haematology, immunology and infectious diseases have been integrating these tools for some decades into what are now wellestablished diagnostic and treatment protocols [12].…”

Integrating Genetics and the Plasma Proteome to Predict the Risk of Type 2 Diabetes

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