Abstract 19961: Protein-based Risk Score Increases Prior to Cardiovascular Events and Death in Individuals With Apparently Stable Coronary Heart Disease
Starting with 1130 plasma proteins, we previously derived and then externally validated a 9 protein model (CVD9 [angiopoietin 2, complement C7, α-2 antiplasmin, matrix metalloproteinase 12, α-1 antichymotrypsin complex, growth differentiation factors 11/8, chemokine (C-C motif) ligand 18, angiopoietin related protein 4 and troponin I]) to predict 4-year probability of death, myocardial infarction, stroke and heart failure using SOMAscan proteomic technology in subjects with stable coronary heart disease (CHD). In the current study, we tested whether this proteomic risk score increases within individuals as they approach an event. We applied CVD9 to paired plasma samples from 513 subjects in the Heart and Soul study who were still event free when a second blood sample was taken 4.8 years after the first. There were 139 subjects who had events a median of 2.9 years after their second sample, compared to 374 subjects who did not have events after their second sample (with a median of 4.3 years of further follow-up). In the events group, CVD9-predicted 4-year event probabilities were higher at baseline (median 24 % vs. 15%, [p<0.001]), and the within-subject increase over 4.8 years was greater as they came closer to their adverse event: +9% vs. +3% [p<0.001] when compared to the no-events group. In contrast, no interval change in the Framingham secondary event prediction score, traditional cardiovascular risk factors, common biomarkers or clinical parameters discriminated between groups in this way. The finding of a protein biomarker panel that is both prognostic at baseline and sensitive to impending events in patients with apparently stable CHD represents a promising advance in personalized risk monitoring.
Author Disclosures: S.A. Williams: Employment; Modest; Venaxis Inc. Employment; Significant; SomaLogic Inc. D. Sterling: Employment; Significant; SomaLogic Inc. S. Kato: Employment; Significant; NEC Corporation of America. R. Ostroff: Employment; Significant; SomaLogic Inc. B. Heidecker: None. M. Whooley: None. P. Ganz: None.
- © 2015 by American Heart Association, Inc.