Abstract 12171: Rho Kinase (ROCK) Activity is a Predictor of Cardiovascular Outcomes in Patients Undergoing Percutaneous Coronary Interventions
Background: Some of the cholesterol-independent or pleiotropic effects of statins could be mediated through inhibition of the Rho/Rho kinase (ROCK) signaling pathway. We hypothesize that statin therapy inhibits the sequential activation of ROCK after percutaneous coronary interventions (PCI) and that the reduction in ROCK activity by statins correlate with subsequent cardiovascular outcomes.
Methods and Results: Leukocyte ROCK activity, cardiac injury markers including troponin T and plasma high-sensitivity C-reactive protein (hsCRP) were measured in 138 consecutive patients at the time before, immediately following PCI, and 24-hours after PCI. Subgroup analysis was performed based upon the level of ROCK activity after PCI and whether patients received pre-treatment with statins. Both statin naïve and statin pre-treated group had similar age, sex and lipid profile distribution. For the entire patient population, ROCK activity increased immediately after PCI (p<0.001). In contrast, troponin T and hsCRP levels were not increased immediately after PCI (both p>0.05), but both were elevated at 24 hours after PCI (p<0.001). Statin naïve patients (n=58) had higher sequential changes in ROCK and hsCRP levels after PCI than those receiving statin pre-treatment (n=80). The ROCK activity in statin-treated patients remained lower 24-hours after PCI (p<0.01) compared to statin naïve patients, and was unrelated to the type of statins used. At 2-years follow-up, higher ROCK activity immediately following PCI (pMBS/tMBS ratio>0.9) was associated with poorer cardiovascular outcomes, including re-infarction, acute or subacute thrombosis, repeated PCI procedures, and re-admission for acute coronary syndrome (p=0.03). Furthermore, patients who were pre-treated with statins had better outcome (p=0.025), especially among those with increased ROCK activity after PCI.
Conclusions: Pre-treatment with statins is associated with lower ROCK activity following PCI procedure and correlated with improved long-term cardiovascular outcomes. These findings suggest that statin therapy is beneficial before PCI procedure and that post-PCI ROCK activity is an important biomarker for predicting long-term cardiovascular outcomes in patients undergoing PCI.
- © 2011 by American Heart Association, Inc.