Authors: An H Bui Marc P Bonaca Marc S Sabatine Kausik K Ray Nader Rifai Christopher P Cannon David A Morrow
Publish Date: 2012/03/24
Volume: 34, Issue: 2, Pages: 222-228
Abstract
Placental growth factor PlGF a member of the vascular endothelial growth factor VEGF family acts via the flt1 receptor and promotes endothelial activation and macrophage recruitment into atherosclerotic lesions We investigated the relationship of PlGF with cardiovascular outcomes in a large cohort of patients presenting across the spectrum of ACS PlGF was measured at baseline n = 3761 and at fourmonths n = 3369 in patients randomized to atorvastatin 80 mg or pravastatin 40 mg after ACS in the PROVE ITTIMI 22 trial The primary endpoint was death myocardial infarction MI unstable angina revascularization or stroke mean followup 24 months Elevated baseline PlGF was associated with a higher incidence of the primary endpoint through 2 years Q1 vs Q5 187 vs 293 p 00001 The risk of death or MI was also higher in patients with elevated baseline PlGF Q1 vs Q5 70 vs 116 p = 0029 Adjusting for baseline characteristics and risk factors elevated baseline PlGF was independently associated with the risk of the primary endpoint adjustedHR for Q5 vs Q1 145 95 CI 116–183 p = 0001 Elevated PlGF at four months was associated with higher risk of death or MI Adjusted HR Q5 vs Q1 279 95 CI 137–568 p = 0005 and higher risk of the primary endpoint Adjusted HR Q5 vs Q1 178 95 CI 126–251 p = 0001 Higher concentration of PlGF after ACS is associated with longterm risk of recurrent cardiovascular events independent of traditional risk factors This association is present early after ACS and appears to be stronger at four monthsPROVE ITTIMI 22 was funded by Bristol Myers Squibb The TIMI Study Group has received significant research grant support from Accumetrics AstraZeneca Bayer Healthcare Beckman Coulter Biosite BristolMyers Squibb CV Therapeutics Daiichi Sankyo Eli Lilly and Co GlaxoSmithKline Merck and Company Nanosphere Novartis Pharmaceuticals OrthoClinical Diagnostics Pfizer Roche Diagnostics SanofiAventis ScheringPlough Siemens and Singulex Dr Sabatine was supported in part by contract HHSN268201000033C from the NHLBI Dr Sabatine also receives research grant support from Abbott BRAHMS Critical Diagnostics Nanosphere and Roche Diagnostics Dr Ray received an unrestricted research grant support from Pfizer Dr Morrow has received honoraria for educational presentations from CV Therapeutics and SanofiAventis He has served as a consultant for Beckman Coulter SanofiAventis Schering Plough and Siemens Drs Bonaca Bui Cannon and Rifai have no additional relationships to report
Keywords: