Circulating N-Linked Glycoprotein Side-Chain Biomarker, Rosuvastatin Therapy, and Incident Cardiovascular Disease: An Analysis From the JUPITER Trial
Circulating N-Linked Glycoprotein Side-Chain Biomarker, Rosuvastatin Therapy, and Incident Cardiovascular Disease: An Analysis From the JUPITER Trial
复制标题
DOI：
10.1161/jaha.116.003822
复制
发表时间：
2016-07-01
影响因子：
5.4
通讯作者：
Mora, Samia
中科院分区：
文献类型：
--
作者：
Akinkuolie, Akintunde O.;Glynn, Robert J.;Mora, Samia
背景：glyca是急性期蛋白n -乙酰侧链的一种新型蛋白聚糖生物标志物，最近被发现与健康女性心血管疾病（CVD）的发生有关。GlycA是否能预测他汀类药物治疗中无CVD但有慢性炎症证据的男性和女性的CVD事件尚不清楚。方法与结果：在他汀类药物用于预防的理由：评估瑞舒伐他汀的干预试验（JUPITER）试验（NCT00239681）中，低密度脂蛋白胆固醇= 2 mg/L的参与者被随机分配到瑞舒伐他汀20 mg/d或安慰剂组。在随机分组前的12527名参与者和1年后的10039名参与者中，通过核磁共振波谱法量化了GlycA。在最长随访5.0年（中位数为1.9年）期间，共发生310例首次原发性CVD事件。研究治疗1年后GlycA变化最小：瑞舒伐他汀组和安慰剂组分别下降6.8%和4.7%。总体而言，基线GlycA水平与CVD风险增加相关：每SD增量的多变量调整风险比（HR）为1.20 （95% CI, 1.08-1.34； P=0.0006）。在额外调整hsCRP后，这种情况略有减弱（HR, 1.18; 95% CI, 1.04-1.35； P=0.01）。治疗时GlycA水平也与CVD相关；相应的多变量调整hsCRP前后每SD的hr: 1.27 （95% CI, 1.13-1.42; P0.20）。结论：在JUPITER试验中，GlycA水平升高与CVD事件风险增加相关，与传统危险因素和hsCRP无关。
Background-GlycA, a novel protein glycan biomarker of N-acetyl side chains of acute-phase proteins, was recently associated with incident cardiovascular disease (CVD) in healthy women. Whether GlycA predicts CVD events in the setting of statin therapy in men and women without CVD but with evidence of chronic inflammation is unknown.Methods and Results-In the Justfication for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial (NCT00239681), participants with low-density lipoprotein cholesterol = 2 mg/L were randomized to rosuvastatin 20 mg/day or placebo. GlycA was quantified by nuclear magnetic resonance spectroscopy in 12 527 before randomization and 10 039 participants at 1 year. A total of 310 first primary CVD events occurred during maximum follow-up of 5.0 years (median, 1.9). GlycA changed minimally after 1 year on study treatment: 6.8% and 4.7% decrease in the rosuvastatin and placebo groups, respectively. Overall, baseline GlycA levels were associated with increased risk of CVD: multivariable-adjusted hazard ratio (HR) per SD increment, 1.20 (95% CI, 1.08-1.34; P=0.0006). After additionally adjusting for hsCRP, this was slightly attenuated (HR, 1.18; 95% CI, 1.04-1.35; P=0.01). On-treatment GlycA levels were also associated with CVD; corresponding multivariable-adjusted HRs per SD before and after additionally adjusting for hsCRP: 1.27 (95% CI, 1.13-1.42; P0.20).Conclusion-In the JUPITER trial, increased levels of GlycA were associated with an increased risk of CVD events independent of traditional risk factors and hsCRP.