Serum amyloid A as a predictor of coronary artery disease and cardiovascular outcome in women - The National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation (WISE)
Serum amyloid A as a predictor of coronary artery disease and cardiovascular outcome in women - The National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation (WISE)
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DOI：
10.1161/01.cir.0000115516.54550.b1
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发表时间：
2004-02-17
期刊：
影响因子：
37.8
通讯作者：
Reis, SE
中科院分区：
文献类型：
--
作者：
Johnson, BD;Kip, KE;Reis, SE
背景-血清淀粉样蛋白-α（SAA）是急性炎症状态的敏感标志物。与高敏C反应蛋白（hs-CRP）一样，SAA与动脉粥样硬化有关。然而，以前的研究已经产生了不一致的结果，冠状动脉疾病（CAD）的严重程度和心血管事件的独立预测价值SAA仍然不清楚。方法和结果-共705名妇女被称为冠状动脉造影怀疑心肌缺血进行血浆SAA和超敏C反应蛋白测定，定量血管造影评估，并随访评估。心血管事件包括死亡、心肌梗死、充血性心力衰竭、卒中和其他血管事件。女性的平均年龄为58岁（范围21至86岁），18%为非白人。SAA和hs-CRP与广泛的CAD危险因素相关。校正这些危险因素后，SAA水平与冠状动脉造影的CAD独立但中度相关（P = 0.004至0.04），并高度预测3年心血管事件（P < 0.0001）。相比之下，hs-CRP与血管造影CAD无关（P = 0.08至0.35），但与SAA一样，是心血管不良结局的独立预测因素（P <0.0001.Conclusions-我们的研究结果显示SAA与未来心血管事件之间有很强的独立关系，与hs-CRP相似。尽管SAA与冠状动脉造影的CAD有独立的中度相关性，但与hs-CRP无相关性。这些结果与假设一致，即全身性炎症，表现为高SAA或hs-CRP水平，可能会促进动脉粥样硬化斑块不稳定，除了施加一个可能的直接影响动脉粥样硬化。
Background - Serum amyloid-alpha (SAA) is a sensitive marker of an acute inflammatory state. Like high-sensitivity C-reactive protein (hs-CRP), SAA has been linked to atherosclerosis. However, prior studies have yielded inconsistent results, and the independent predictive value of SAA for coronary artery disease ( CAD) severity and cardiovascular events remains unclear.Methods and Results - A total of 705 women referred for coronary angiography for suspected myocardial ischemia underwent plasma assays for SAA and hs-CRP, quantitative angiographic assessment, and follow-up evaluation. Cardiovascular events were death, myocardial infarction, congestive heart failure, stroke, and other vascular events. The women's mean age was 58 years ( range 21 to 86 years), and 18% were nonwhite. SAA and hs-CRP were associated with a broad range of CAD risk factors. After adjustment for these risk factors, SAA levels were independently but moderately associated with angiographic CAD ( P = 0.004 to 0.04) and highly predictive of 3-year cardiovascular events ( P < 0.0001). By comparison, hs-CRP was not associated with angiographic CAD ( P = 0.08 to 0.35) but, like SAA, was strongly and independently predictive of adverse cardiovascular outcome ( P < 0.0001).Conclusions - Our results show a strong independent relationship between SAA and future cardiovascular events, similar to that found for hs-CRP. Although SAA was independently but moderately associated with angiographic CAD, this association was not found for hs-CRP. These results are consistent with the hypothesis that systemic inflammation, manifested by high SAA or hs-CRP levels, may promote atherosclerotic plaque destabilization, in addition to exerting a possible direct effect on atherogenesis.