Abstract 11051: Soluble Fms-Like Tyrosine Kinase 1 is a Novel Predictor of Cardiovascular Disease Progression in Patients with Coronary Artery Disease
Purpose: Soluble Fms-like tyrosine kinase 1 (sFlt-1) is an endogenous inhibitor of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF), which are involved in cardiovascular remodeling and the development of atherosclerosis. Circulating level of sFlt-1 is reported to be positively associated with the presence of coronary artery disease (CAD). To examine the predictive role of sFlt-1 in patients with CAD, we measured circulating sFlt-1 in patients with or without CAD.
Methods: To examine the relation between sFlt-1 and CAD, we analyzed 122 patients with CAD or who are at high-risk for atherosclerosis undergoing total risk management for cardiovascular disease prevention in the Kitasato Registry for Cardiovascular Disease Prevention (average age, 65.9 years; 28.7% women). The follow-up period was 5 years for all patients. Serum levels of sFlt-1 were measured by ELISA.
Results: Of all patients, 63.9% had CAD, 57.4% had hypertension, 62.3% had dyslipidemia, 31.1% had diabetes mellitus, and 27.9% had previous myocardial infarction (MI). The baseline level of serum sFlt-1 was 167.2 (89.6) (mean [SD]) ng/mL. The serum sFlt-1 level correlated with CAD, previous MI, and men. Circulating levels of sFlt-1 were significantly elevated in patients with CAD (n = 78) compared to those in patients without CAD (182.4 [105.6] vs. 140.2 [40.5] ng/mL, P < 0.05). Baseline levels of sFlt-1 were correlated with an increase in plasma BNP levels (ΔBNP) from baseline to 5 years later (r = 0.262, P < 0.05) in CAD patients, but not in 44 patients without CAD. When the patients were divided into 2 groups, i.e., high-sFlt-1 group and low-sFlt-1 group, ΔBNP levels were significantly higher in the high-sFlt-1 group compared to the low-sFlt-1 group (P < 0.0001). ΔBNP was significantly correlated with sFlt-1 in CAD patients in the high-sFlt-1 group (r = 0.510, P < 0.01), but not in the low-sFlt-1 group.
Conclusions: The present 5-year follow-up study demonstrates that circulating levels of sFlt-1 were increased in patients with CAD, and high sFlt-1 levels in patients with CAD were indicative of a moderate increase in BNP levels. These data suggest that high sFlt-1 levels may be an effective biomarker to predict the progression of heart failure in patients with CAD.
- © 2011 by American Heart Association, Inc.