Abstract 12973: Placental Growth Factor as a Predictor of Cardiovascular Events Following Coronary Drug-eluting Stent Implantation
Background: Placental growth factor (PlGF), a member of the vascular endothelial growth factor (VEGF) family, plays a role in the initiation of inflammation in atherosclerotic lesions. PlGF also serves as a marker of prognosis in patients with acute coronary syndrome. However, the predictive value of PlGF in patients who undergo coronary drug-eluting stent (DES) implantation is unknown.
Methods and Results: We enrolled 341 patients who underwent successful coronary DES implantation (257 everolimus-eluting stents, 49 biolimus-eluting stents, 27 sirolimus-eluting stents, and 8 others). Patients were followed up over 30 months. The median follow-up was 372 (inter-quartile range, 282-523) days. Pre-procedural serum levels of high-sensitivity CRP (hsCRP), VEGF, and PlGF were measured by specific enzyme-linked immunosorbent assays. Major adverse cardiovascular events (MACE) were defined as cardiovascular death and hospitalization due to acute coronary syndrome, stroke, heart failure, and coronary angioplasty. During the follow-up period, MACE developed in a total of 59 patients (17.3%). Patients were divided into two groups based on the optimal cut-off value of each biomarker determined by receiver operating characteristic curve (ROC) analyses. In Kaplan-Meier analyses, high-hsCRP and high-PlGF, but not high-VEGF, were significantly associated with MACE (P = 0.03, P = 0.003, and P = 0.055 by log-rank test, respectively). Stepwise Cox proportional hazard analysis, including established risk factors, high-hsCRP, high-VEGF, high-PlGF, and the type of DES, revealed that high-PlGF, but not high-hsCRP and high-VEGF, was independently associated with MACE (adjusted hazard ratio, 2.7; 95% confidence interval, 1.4 to 4.9; P = 0.002). Serum levels of PlGF were also significantly associated with MACE, even after adjusting for established risk factors and type of DES (adjusted hazard ratio, 1.23 for 1-SD increase; 95% confidence interval, 1.03 to 1.5; P = 0.02).
Conclusions: Serum levels of PlGF, but not hsCRP or VEGF, were independently associated with MACE. A high PlGF value may serve as a predictor of MACE following coronary DES implantation.
- © 2013 by American Heart Association, Inc.