Abstract 13960: Stromal Derived Factor -1 Level Predicts Long-Term Adverse Cardiovascular Outcomes in Patients With Stable Coronary Artery Disease
Background: Stromal Derived Factor-1 (SDF-1) is a powerful chemoattractant with enhanced expression following ischemia and is responsible for homing of progenitor cells to injured tissues. Whether higher levels of SDF-1 are associated with long term adverse outcomes in patients with coronary artery disease (CAD) remains unknown.
Methods: 156 patients with stable CAD (Age: 62±10, 83% male, 42% diabetic, 86% hypertensive) underwent PCI and stenting. Baseline pre-PCI levels of plasma SDF-1 were measured using Quantikine CXCl12/SDF-1 ELISA assay (R&D systems). Patients were followed for cardiovascular (CV) death and/or myocardial infarction (MI) for a median of 5.8 yrs. Cox proportional hazard was used to determine independent predictors of death/MI. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were calculated using SAS.
Results: The incidence of CV death/MI was 26% (N=41). Independent predictors of CV death/MI were serum levels of CRP (HR: 1.04, P=0.001), creatinine (HR: 9.73, p<0.001) and SDF-1 level (HR: 1.001, P=0.002) after adjustment of all conventional risk factors. An SDF-1 cutoff of 1723.4 pg. /ml was determined using Youden’s index. Compared to those with SDF-1 levels below cutoff, the hazard ratio (HR) for Cardiovascular death/MI was 3.36 (p=0.001) for those with high SDF-1 level. Discrimination analyses demonstrated significant improvements in NRI [0.75(0.41, 1.06)], and IDI [0.032(0.0029, 0.0698)].
Conclusion: Plasma SDF-1 levels are associated with worse long-term outcomes in patients with stable CAD independent of CRP levels and significantly improve risk re-classification.
- © 2013 by American Heart Association, Inc.