Abstract 14004: Plasma Soluble Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1 Level at Admission can Predict Mortality in Patients with Acute Myocardial Infarction
Background: Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) appears to play an important role in the atherosclerotic plaque vulnerability and rupture. LOX-1 is cleaved and released as soluble LOX-1 (sLOX-1), and elevated sLOX-1 level may be indicative of plaque instability. sLOX-1 level was shown to be a sensitive and specific biomarker for diagnosing acute coronary syndrome (ACS). Recently, sLOX-1 level was shown to be a reliable prognostic biomarker after ACS. It is unclear how the plasma sLOX-1 level at the acute phase is related to the prognosis in patients with acute myocardial infarction (AMI).
Methods and Results: We examined the relation between sLOX-1 level at admission and mortality prospectively in the consecutive 153 AMI patients admitted within 24 hours after the onset. The patients were divided into 2 groups by the median value (71 pg/ml) of plasma sLOX-1 level at admission: those with sLOX-1 level <71 pg/ml (n=77, LOW) and >72 pg/ml (n=76, HIGH) and followed for median of 1156 days. None of age, sex, lipid profile or prevalence of diabetes, smoking, hypertension, or Killip class>3 was significantly different between the 2 groups. All-cause mortality was significantly higher in HIGH than in LOW (25.0% vs 3.9%, p<0.001 by Log-rank test). All-cause 30-day mortality and mortality after 30 days were significantly both higher in HIGH than in LOW (9.2% vs 1.3%, p=0.029 and 17.4% vs 2.7%, p=0.002, respectively). Multivariate analysis revealed that age (hazard ratio (HR), 1.102; 95% confidence interval (CI): 1.040-1.167, p=0.001), sLOX-1 (HR, 1.008; 95%CI: 1.005-1.012, p<0.001), troponin T (HR, 1.088; 95%CI: 1.024-1.155, p=0.006), and high-sensitivity C-reactive protein (hs-CRP) (HR, 1.000; 95%CI: 1.000-1.000, p<0.001) were significantly associated with all-cause mortality, and age (HR, 1.111; 95%CI: 1.003-1.231, p=0.044), sLOX-1 (HR, 1.008; 95%CI: 1.004-1.013, p<0.001), and hs-CRP (HR, 1.000; 95%CI: 1.000-1.000, p=0.009) with all-cause 30-day mortality. sLOX-1 was not an independent predictor for all-cause mortality after 30 days (HR, 1.004; 95%CI: 0.998-1.010, p=0.205).
Conclusion: The plasma sLOX-1 level at admission is a strong and independent predictor for mortality in AMI, especially for 30 days after AMI.
- © 2012 by American Heart Association, Inc.