Introduction We examined whether the acute phase proteins (APPs): Alpha-1-Antitrypsin, Alpha-2-Macroglobulin, Complement C3, ferritin, haptoglobin, and Plasminogen Activator Inhibitor 1 (PAI-1) are associated with cardiovascular outcome, as well as with the extent and composition of coronary atherosclerosis as determined by intravascular ultrasound (IVUS) virtual histology (VH).Methods In 2008-2011, IVUS(-VH) imaging of a non-culprit coronary artery was performed in 581 patients from the ATHEROREMO-IVUS study undergoing coronary angiography for acute coronary syndrome (ACS) (n = 318) or stable angina pectoris (SAP) (n = 263). Coronary atherosclerotic plaque volume, composition (fibrous, fibro-fatty, dense calcium and necrotic core) and vulnerability (VH-derived thin-cap fibroatheroma (TCFA) lesions) were assessed. Major adverse cardiac events (MACE; all-cause mortality, ACS or unplanned coronary revascularization) were assessed during 1-year follow-up. We applied linear, logistic and Cox regression.Results Mean age was 61.5 ± 11.4 years and 75.4% were men. Higher ferritin was associated with higher coronary plaque volume (beta [95% CI]: 0.19 [0.07-0.31] percent atheroma volume), for the highest vs the lowest tertile of ferritin; p for linear association = 0.013. Higher PAI-1 was associated with higher rates of all-cause mortality or ACS (hazard ratio [95% CI]: 2.98 [1.10-8.06]), for the highest vs the lowest tertile of PAI-1. No clear-cut associations could be demonstrated between APPs and composition of atherosclerosis or plaque vulnerability.Conclusions Higher circulating ferritin was associated with higher coronary plaque volume, and higher PAI-1 was associated with higher incidence of all-cause mortality or ACS. None of the APPs displayed consistent associations with composition of atherosclerosis or plaque vulnerability.

Additional Metadata
Keywords Acute coronary syndrome, Acute phase proteins, Atherosclerosis, Intravascular ultrasound
Persistent URL dx.doi.org/10.1016/j.ijcard.2014.11.001, hdl.handle.net/1765/83626
Journal International Journal of Cardiology
Citation
Battes, L.C, Akkerhuis, K.M, Cheng, J.M, Garcia-Garcia, H.M, Oemrawsingh, R.M, de Boer, S.P.M, … Kardys, I. (2014). Circulating acute phase proteins in relation to extent and composition of coronary atherosclerosis and cardiovascular outcome: Results from the ATHEROREMO-IVUS study. International Journal of Cardiology, 177(3), 847–853. doi:10.1016/j.ijcard.2014.11.001