Abstract 13575: Clinical Significance of S100A8/A9 Complex, Myeloperoxidase, Neopterin, and High Sensitivity C-reactive Protein as Independent Predictors of Cardiovascular Events after Drug-Eluting Stent Implantation in Patients with Stable Angina Pectoris
Background: Drug-eluting stents (DES) have reduced the rate of restenosis, although recurrent angina and repeat revascularization remain major limitations. We previously demonstrated that several inflammatory biomarkers such as S100A8/A9 complex, neopterin and myeloperoxidase (MPO) were important in the pathogenesis of coronary plaque instability. We assessed the prognostic significance of these biomarkers in stable angina pectoris (SAP) patients after DES implantation.
Methods: S100A8/A9 complex, neopterin, MPO and high-sensitivity C-reactive protein (hs-CRP) were measured in 143 SAP patients. Measurements were taken at baseline (before DES implantation) and at the chronic phase (2 weeks after DES implantation). Cardiac events were defined as sudden cardiac death, fatal or non-fatal myocardial infarction and other non-fatal events including unstable angina pectoris or coronary revascularization.
Results: S100A8/A9 complex and neopterin levels at the chronic phase were significantly increased compared with baseline (MRP-8/14, P<0.0005; neopterin, P<0.0001). In contrast, MPO and hs-CRP levels at the chronic phase had not significantly changed compared with baseline. Over a mean follow-up period of 27±17 months, 41 patients (29%) had cardiac events. Patients were classified into 2 groups based on the median S100A8/A9 complex, neopterin, MPO and hs-CRP values at the chronic phase. Kaplan-Meier survival curves showed that outcomes were significantly worse in the high-S100A8/A9 complex group than in the low-S100A8/A9 complex group (P=0.034). However, there were no significant differences in cardiovascular events when patients were divided according to the median neopterin, MPO or hs-CRP values at the chronic phase. Multivariate analysis showed that an elevated level of S100A8/A9 complex at the chronic phase was the only independent predictor of cardiovascular events (odds ratio, 2.805; 95% confidence interval, 1.15 to 6.87; P=0.024).
Conclusions: These findings suggest that the persistence of increased levels of S100A8/A9 complex are closely related to restenosis or plaque instability in SAP patients after DES implantation compared with other biomarkers.
- © 2012 by American Heart Association, Inc.