Prognostic Impact of Soluble P-Selectin on Long-Term Adverse Cardiovascular Outcomes in Patients Undergoing Percutaneous Coronary Intervention

Maximilian Tscharre; Birgit Vogel; Ioannis Tentzeris; Matthias K. Freynhofer; Miklos Rohla; Johann Wojta; Thomas W. Weiss; Cihan Ay; Kurt Huber; Serdar Farhan

doi:10.1055/s-0038-1676563

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2019; 119(02): 340-347
DOI: 10.1055/s-0038-1676563

Atherosclerosis and Ischaemic Disease

Georg Thieme Verlag KG Stuttgart · New York

Prognostic Impact of Soluble P-Selectin on Long-Term Adverse Cardiovascular Outcomes in Patients Undergoing Percutaneous Coronary Intervention

Autoren

Maximilian Tscharre

¹3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenspital, Vienna, Austria

²Institute for Cardiometabolic Diseases, Karl Landsteiner Society, St. Pölten, Austria
Birgit Vogel

¹3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenspital, Vienna, Austria

³The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Ioannis Tentzeris

¹3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenspital, Vienna, Austria
Matthias K. Freynhofer

¹3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenspital, Vienna, Austria

⁴Sigmund Freud University Medical School, Sigmund Freud University, Vienna, Austria
Miklos Rohla

¹3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenspital, Vienna, Austria

²Institute for Cardiometabolic Diseases, Karl Landsteiner Society, St. Pölten, Austria
Johann Wojta

⁵Division of Cardiology, Department of Internal Medicine 2, Medical University of Vienna, Vienna, Austria

⁶Core Facilities, Medical University of Vienna, Vienna, Austria

⁷Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
Thomas W. Weiss

¹3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenspital, Vienna, Austria

²Institute for Cardiometabolic Diseases, Karl Landsteiner Society, St. Pölten, Austria

⁴Sigmund Freud University Medical School, Sigmund Freud University, Vienna, Austria
Cihan Ay

⁸Clinical Division of Haematology and Haemostaseology, Department of Medicine 1, Medical University of Vienna, Vienna, Austria

⁹I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
Kurt Huber

¹3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenspital, Vienna, Austria

⁴Sigmund Freud University Medical School, Sigmund Freud University, Vienna, Austria
Serdar Farhan

¹3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenspital, Vienna, Austria

³The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States

Abstract

Background Soluble P-selectin (sP-selectin), a biomarker of inflammatory pathologies including cardiovascular disease, is known to have pro-atherosclerotic effects such as the ability to increase leukocyte recruitment and modulate thrombotic response. We aimed to assess the impact of sP-selectin on long-term major adverse cardiovascular events (MACE) in patients after coronary stenting for coronary artery disease.

Methods We analysed 733 patients of a single-centre registry undergoing percutaneous coronary intervention (PCI) between 2003 and 2006. Plasma samples were analysed for sP-selectin antigen concentration with an enzyme-linked immunoassay. The study population was categorized according to sP-selectin quartiles. Endpoint of the study was long-term MACE, a composite of all-cause death, myocardial infarction (MI) and stroke.

Results Of the total patient cohort, 361 (49.2%) patients were admitted for stable coronary artery disease and 372 (50.8%) for acute coronary syndrome. Median age was 64 years and 70.7% were male. After a mean follow-up period of 9.7 years, MACE occurred in 344 (46.9%) patients. The primary endpoint components of all-cause death occurred in 211 (28.8%), MI in 88 (12.0%) and ischaemic stroke in 45 (6.1%) patients. After adjustment for confounders, patients in the 2nd, 3rd and 4th quartile were at higher risk for MACE compared with the 1st quartile (hazard ration [HR], 1.234 [0.899–1.695], p = 0.193; HR, 1.480 [1.085–2.019], p = 0.013; and HR, 1.571 [1.115–2.152], p = 0.004). sP-selectin as continuous variable model was significantly associated with MACE after adjustment (HR per 1 ng/mL increase of 1.009 [95% confidence interval, 1.002–1.017]; p = 0.016).

Conclusion Elevated levels of sP-selectin were associated with increased risk for long-term MACE in patients undergoing PCI.

Keywords

soluble P-selectin - percutaneous coronary intervention - long-term major adverse cardiovascular outcome

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Referenzen

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