Abstract 18791: Serum Ceruloplasmin Independently Predicts Cardiovascular Risk in Stable Cardiac Patients
Background: Ceruloplasmin (Cp) is an acute-phase reactant that is increased in inflammatory diseases and in acute coronary syndromes. Recently Cp has been demonstrated to oxidize nitric oxide (NO), thereby promoting endothelial dysfunction and vasculopathy. The prognostic value of ceruloplasmin has not been explored in a contemporary stable cardiac patient population.
Methods: We measured serum Cp levels in 3,569 consecutive stable patients undergoing elective coronary angiography with available leukocyte counts and high-sensitivity C-reactive protein (hsCRP) levels. We examine the role of Cp in predicting incident major adverse cardiac events (MACE = death, myocardial infarction [MI], stroke) over 3 years of follow-up.
Results: In our cohort (age 63±11 years, 66% male, 32% history of MI, 30% diabetes mellitus), mean Cp level was 24±6 mg/dL, and demonstrated strong correlation with high-sensitivity C-reactive protein (hsCRP, r=0.52, p<0.01) but not to uric acid (r=0.02, p=0.19) and only modestly to leukocyte count (r=0.15, p<0.01). Ceruloplasmin level (Quartiles 4 vs 1) was associated with almost 3-fold increase in risk of future MACE at 1 year (Hazard ratio [HR] 2.93, 95%CI 1.87–4.58, p<0.001) and at 3 years (HR 2.14, 95%CI 1.61–2.84, p<0.01. After adjusting for traditional risk factors including hsCRP, and total leukocyte count, Cp remained independently predictive of MACE at 1 year (HR 2.51, 95% CI 1.40–4.49, p=0.001) and at 3 years (HR 1.48, 95%CI 1.01–1.26). There were no interactions between Cp and statin use (p=0.66).
Conclusions: In stable cardiac patients, serum Cp provides risk prediction of intermediate- and long-term adverse cardiac events independent of inflammation markers.
- © 2010 by American Heart Association, Inc.