Abstract 3743: Procalcitonin For Risk Stratification In Stable Coronary Artery Disease. Results From The Atherogene Study
Background: Procalcitonin (PCT) is a well-established biomarker for diagnosing and monitoring sepsis. In vitro-studies showed that PCT has an effect on monocyte activation and even on nitric oxide synthesis. We examined the prognostic impact of PCT in patients with coronary artery disease (CAD) on cardiovascular outcome.
Methods: In a substudy of the propective AtheroGene survey, we assessed in 1124 patients with stable CAD, the risk of cardiovascular death and non-fatal myocardial infarction (N=72) over a median follow-up of 3.8 (max. 6.8) years according to the baseline concentration of PCT.
Results: The age- and sex-adjusted hazard ratio for patients within the highest quartile of PCT related a 2.27-fold increase (95% confidence interval (CI): 1.14 – 4.51; P=0.02) of the relative risk for future cardiovascular events, when compared to the first quartile. Adjustment for classical risk factors and clinical variables attenuated this relationship not significantly. Inclusion of one SD increase of PCT improved the predictive value of a basic model (classical risk factors) for cardiovascular risk prediction monitored by the area under the curve of an ROC-curve, reporting an increase from 0.74 (95% CI: 0.67–0.81) to 0.77 (95% CI: 0.70–0.84). PCT even provided further information on top of that obtained from the established biomarker B-type natriuretic peptide (BNP). Thus, individuals with a combined elevation of PCT and BNP above the fourth quartile border revealed a 7.04-fold (95% CI: 3.40–14.57; P<0.001) higher cardiovascular risk.
Conclucions: Baseline concentration of PCT is independently related to future cardiovascular events in patients with stable CAD.