Aggregate Risk Score Based on Markers of Inflammation, Cell Stress, and Coagulation Is an Independent Predictor of Adverse Cardiovascular Outcomes

Objectives: This study sought to determine an aggregate, pathway-specific risk score for enhanced prediction of death and myocardial infarction (MI). Background Activation of inflammatory, coagulation, and cellular stress pathways contribute to atherosclerotic plaque rupture. We hypothesized that an aggregate risk score comprised of biomarkers involved in these different pathways - high-sensitivity C-reactive protein (CRP), fibrin degradation products (FDP), and heat shock protein 70 (HSP70) levels - would be a powerful predictor of death and MI. Methods: Serum levels of CRP, FDP, and HSP70 were measured in 3,415 consecutive patients with suspected or confirmed coronary artery disease (CAD) undergoing cardiac catheterization. Survival analyses were performed with models adjusted for established risk factors. Results: Median follow-up was 2.3 years. Hazard ratios (HRs) for all-cause death and MI based on cutpoints were as follows: CRP ≥3.0 mg/l, HR: 1.61; HSP70 >0.625 ng/ml, HR; 2.26; and FDP ≥1.0 μg/ml, HR: 1.62 (p < 0.0001 for all). An aggregate biomarker score between 0 and 3 was calculated based on these cutpoints. Compared with the group with a 0 score, HRs for all-cause death and MI were 1.83, 3.46, and 4.99 for those with scores of 1, 2, and 3, respectively (p for each: <0.001). Annual event rates were 16.3% for the 4.2% of patients with a score of 3 compared with 2.4% in 36.4% of patients with a score of 0. The C statistic and net reclassification improved (p < 0.0001) with the addition of the biomarker score. Conclusions: An aggregate score based on serum levels of CRP, FDP, and HSP70 is a predictor of future risk of death and MI in patients with suspected or known CAD

Abstract 15230: Depression is a Stronger Risk Factor for Obstructive Coronary Artery Disease and Major Cardiovascular Events in Young Women than Men and Older Women

Introduction: Depression is a cardiovascular risk factor that is highly prevalent in young women, a group that also shows a disproportionately increased risk of adverse events after an acute MI. We..

Abstract 15086: Mean Platelet Volume is an Independent Predictor of Acute Myocardial Infarction and Future Adverse Cardiovascular Outcomes in Individuals with Coronary Artery Disease

Background: Mean Platelet Volume (MPV) is a readily available estimate of platelet size in circulating blood and may be a marker of cardiovascular (CV) risk. We hypothesized that elevated MPV is a ..

AN AGGREGATE OF PATHWAY-RELATED BIOMARKERS PREDICT RISK OF ACUTE MYOCARDIAL INFARCTION AND DEATH

Activation of diverse pathophysiologic processes that include thrombotic, inflammatory, and immune pathways contribute to plaque rupture and adverse outcomes in CAD. We hypothesized that an aggregate biomarker risk score comprised of C-reactive protein (CRP), fibrin degradation products (FDP)

Abstract 17927: A Cumulative Family History Score is Associated with Greater Severity and Progression of Angiographic Coronary Artery Disease

Introduction: A family history (FH) of coronary heart disease (CHD) is a significant risk factor for development of atherosclerosis. We sought to determine whether a greater number of affected firs..