Abstract 3076: Elevated levels of Placental Growth Factor (PlGF) and Long Term Risk in Patients with Acute Coronary Syndrome in PROVE IT-TIMI 22
Placental growth factor (PlGF) is a vascular endothelial growth factor and an emerging biomarker of cardiovascular risk. Initial studies suggest that elevated levels are associated with increased risk of recurrent events in patients who present with acute coronary syndromes (ACS). The available data, however, are relatively few and require support from additional robustly sized studies.
METHODS: We measured PlGF (R&D ELISA) at randomization (N = 3761) and at 4 months (N=3369) in patients who were stabilized after ACS and enrolled in the PROVE IT-TIMI 22 Trial. Patients were followed for an average of 24 months.
RESULTS: Elevated baseline levels of PlGF were associated with higher risk of death or MI (Q1 vs Q5: 7.0% vs 11.6%, p = 0.029) as well as the primary endpoint of death, MI, unstable angina, revascularization or CVA (Q1 vs Q5: 18.7% vs 29.3%, p<0.0001). After adjustment for age, gender, diabetes, smoking, index event, LDL and CRP, elevated levels of PlGF were independently associated with the risk of the primary endpoint (adj HR for Q5 vs Q1 1.45; 95% CI 1.16 – 1.83). Upon evaluation at 4 months, the relationship between PlGF and subsequent events appeared stronger, both for death or MI (Figure⇓) and the primary endpoint (adj HR Q5 vs Q1: 1.78 95% CI 1.26 – 2.51).
CONCLUSIONS: Increased levels of PlGF measured both early and late after ACS are independently associated with long-term risk of recurrent cardiovascular events. This finding adds to the emerging evidence supporting PlGF as a prognostic marker and potential therapeutic target in patients with ACS.