Abstract P353: Serum Levels of Monocyte Chemoattractant Protein-1 and All-cause and Cardiovascular Mortality among Patients with Coronary Artery Disease
Background: Monocyte chemoattractant protein-1 (MCP-1) is an important chemokine at multiple phases of atherosclerosis in animal studies, but results of human studies are inconsistent.
Objective: To investigate the association of serum MCP-1with all-cause and CVD mortality among CAD patients and determine whether the novel biomarker can add secondary prognostic value to standard risk predictors.
Methods: MCP-1 was measured at baseline in 1411 CAD patients who were 40-85 years of age in the Guangdong Coronary Artery Disease Cohort. Cox proportional hazards regression models were used to estimate the association of different levels of serum MCP-1with risk of mortality.
Results: During a median follow-up of 3.3 years, 117 deaths were recorded, 88 of which were due to CVD. The multivariable-adjusted (age, sex, education, occupation, marriage, leisure-time physical activity, smoking, alcohol drinking, body mass index, systolic blood pressure, fasting plasma glucose, low-density lipoprotein cholesterol, glomerular filtration rate, type, severity, duration, and treatment of CAD, history of heart failure, and use of antihypertensive, anti-diabetic, cholesterol-lowering, and anti-platelet drugs) hazard ratios across tertiles of MCP-1 were 1.52 (95% CI 0.90-2.57), 1.00, and 1.93 (95% CI 1.20-3.10) for all-cause mortality, and 1.38 (95% CI 0.75-2.55), 1.00, and 1.93 (95% CI 1.12-3.34) for CVD mortality. Further adjusting for C-reactive protein, all the hazard ratios remained similar. The addition of MCP-1 increased the C-statistic of the fully adjusted all-cause mortality model from 0.811 to 0.820 (p<0.0001) and the CVD mortality model from 0.827 to 0.835 (p<0.0001). After stratifying CAD type, age, gender, body mass index and C-reactive protein levels, the associations became stronger in acute coronary syndrome, males, normal-weight, and elevated C-reactive protein subgroups, while the hazard ratios turned insignificant in stable performance, females, obese, and normal C-reactive protein subgroups.
Conclusions: Elevated MCP-1 level is associated with an increased risk of all-cause and CVD mortality among CAD patients. MCP-1 can add prognostic value to standard risk predictors and merits further study.
Author Disclosures: D. Ding: None. D. Su: None. X. Li: None. Z. Li: None. J. Qiu: None. P. Lin: None. Y. Zhang: None. M. Wang: None. X. Lv: None. M. Xia: None. G. Hu: None. W. Ling: None.
- © 2014 by American Heart Association, Inc.