Significance of a Multiple Biomarkers Strategy Including Endothelial Dysfunction to Improve Risk Stratification for Cardiovascular Events in Patients at High Risk for Coronary Heart Disease
Toshimitsu Nozaki, MD*,
Seigo Sugiyama, MD, PhD*,*,
Hidenobu Koga, MD, PhD*,
Koichi Sugamura, MD*,
Keisuke Ohba, MD*,
Yasushi Matsuzawa, MD*,
Hitoshi Sumida, MD, PhD ,
Kunihiko Matsui, MD, PhD ,
Hideaki Jinnouchi, MD, PhD and
Hisao Ogawa, MD, PhD*
* Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
Department of Interventional Cardiology, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
Department of General Medicine, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
Jinnouchi Hospital, Kumamoto, Japan
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Figure 1 Flow Diagram of Subject Recruitment
Thirty-one patients were excluded for the following reasons: malignant diseases (n = 20), unstable conditions (n = 6), systemic inflammatory disease (n = 3), and active infections (n = 2). ACS = acute coronary syndromes; CAD = coronary artery disease; CHD = coronary heart disease.
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Figure 2 Plasma Levels of CD144-EMP in Patients With Various Cardiovascular Risks
The line within the box represents the median value; the top and bottom lines of the box represent the 25th and 75th percentiles, respectively; and the top and bottom vertical lines outside the boxes represent the 90th and 10th percentiles, respectively. ANOVA = analysis of variance; EMP = endothelium-derived microparticle; other abbreviations as in Figure 1.
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Figure 3 Kaplan-Meier Analysis for the Probability of Cardiovascular Events
(A to C) Based on each cutoff point of B-type natriuretic peptide (BNP), high-sensitivity C-reactive protein (hsCRP), and CD144 endothelium-derived microparticles (EMP). BNP 52.6 pg/ml, hsCRP 2.0 mg/l, and CD144-EMP 0.569 x 106/ml.
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