Monocyte Chemoattractant Protein-1 Is an Independent Predictor of Coronary Artery Ectasia in Patients with Acute Coronary Syndrome

Abstract

Our purpose was to assess a possible association of inflammatory, lipid and mineral metabolism biomarkers with coronary artery ectasia (CAE) and to determine a possible association of this with acute atherotrombotic events (AAT). We studied 270 patients who underwent coronary angiography during an acute coronary syndrome 6 months before. Plasma levels of several biomarkers were assessed, and patients were followed during a median of 5.35 (3.88–6.65) years. Two interventional cardiologists reviewed the coronary angiograms, diagnosing CAE according to previously published criteria in 23 patients (8.5%). Multivariate binary logistic regression analysis was used to search for independent predictors of CAE. Multivariate analysis revealed that, aside from gender and a diagnosis of dyslipidemia, only monocyte chemoattractant protein-1 (MCP-1) (OR = 2.25, 95%CI = (1.35–3.76) for each increase of 100 pg/mL, p = 0.001) was independent predictor of CAE, whereas mineral metabolism markers or proprotein convertase subtilisin/kexin type 9 were not. Moreover, CAE was a strong predictor of AAT during follow-up after adjustment for other clinically relevant variables (HR = 2.67, 95%CI = (1.22–5.82), p = 0.013). This is the first report showing that MCP-1 is an independent predictor of CAE, suggesting that CAE and coronary artery disease may share pathogenic mechanisms. Furthermore, CAE was associated with an increased incidence of AAT.

Treatment and Outcome of Patients With Coronary Artery Ectasia: Current Evidence and Novel Opportunities for an Old Dilemma

“…The extreme proteolysis of extracellular matrix (ECM) weakens the vessel architecture, increase the wall stress, and reduce vessel tolerance to blood flow, thus predisposing to the progressive dilatation of the artery. Moreover, chronic inflammation further contributes to arterial wall damage and dilatation, as demonstrated by the correlation between high levels of inflammatory markers and the presence and the severity of CAE (36)(37)(38). However, while inflammation represents one of the major features of the pathophysiology and natural history of atherosclerosis, recent findings demonstrated an increased inflammatory status in patients with CAE compared to those with CAD alone, with significantly higher levels of circulating cytokines (39).…”

Association Between Circulating Proprotein Convertase Subtilisin/Kexin Type 9 Concentrations and Cardiovascular Events in Cardiovascular Disease: A Systemic Review and Meta-Analysis

“…Of the 11 studies included, only 1 ( 22 ) was a retrospective cohort study and the others were prospective cohort studies, with a publication period from 2014 to 2020. Four trials ( 20 , 22 , 27 , 28 ) reported RRs according to continuous concentrations of PCSK9, three studies ( 19 , 24 , 26 ) reported RRs according to categorical levels, and four studies ( 8 , 21 , 23 , 28 ) reported RRs according to both continuous and categorical levels. We included 8,471 patients, and the sample size of each study ranged from 249 to 2,030.…”

“…We included 8,471 patients, and the sample size of each study ranged from 249 to 2,030. The longest follow-up was 5.35 years ( 20 ), and the mean weighted follow-up was 1.42 years. The baseline serum PCSK9 concentrations ranged from 52.1 to 607 ng/ml (weighted mean, 283.8 ng/ml).…”

“…Table 1 shows the characteristics of the included studies (8,9,(19)(20)(21)(22)(23)(24)(26)(27)(28). Of the 11 studies included, only 1 ( 22) was a retrospective cohort study and the others were prospective cohort studies, with a publication period from 2014 to 2020.…”

The Value of Fetuin-A as a Predictor to Identify Takotsubo Patients at Risk of Cardiovascular Events

“…In patients with acute coronary syndrome, higher plasma levels of galectin-3 levels were found to be associated with poor survival rate [38]. Furthermore, high FGF-23 plasma levels have been shown to predict mortality and cardiovascular events [39,40], hs troponin and in further biomarker analysis, Galectin-3 didn't have a prognostic relevance in TTC. Galectin-3 was neither predictive for cardiac decompensation (rs: −0.152; p: 0.293), for arrhythmias (rs: −0.002; p: 0.990) nor all-cause complications (rs: −0.177, p: 0.219).…”