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Arterioscler Thromb Vasc Biol. 2010 Mar;30(3):612-9. doi: 10.1161/ATVBAHA.109.194944. Epub 2009 Dec 17.

Local atherosclerotic plaques are a source of prognostic biomarkers for adverse cardiovascular events.

Author information

1
Experimental Cardiology (G02523), UMC, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands.

Abstract

OBJECTIVE:

Atherosclerotic cardiovascular disease is a major burden to health care. Because atherosclerosis is considered a systemic disease, we hypothesized that one single atherosclerotic plaque contains ample molecular information that predicts future cardiovascular events in all vascular territories.

METHODS AND RESULTS:

AtheroExpress is a biobank collecting atherosclerotic lesions during surgery, with a 3-year follow-up. The composite primary outcome encompasses all cardiovascular events and interventions, eg, cardiovascular death, myocardial infarction, stroke, and endovascular interventions. A proteomics search identified osteopontin as a potential plaque biomarker. Patients undergoing carotid surgery (n=574) served as the cohort in which plaque osteopontin levels were examined in relation to their outcome during follow-up and was validated in a cohort of patients undergoing femoral endarterectomy (n=151). Comparing the highest quartile of carotid plaque osteopontin levels with quartile 1 showed a hazard ratio for the primary outcome of 3.8 (95% confidence interval, 2.6-5.9). The outcome did not change after adjustment for plaque characteristics and traditional risk factors (hazard ratio, 3.5; 95% confidence interval, 2.0-5.9). The femoral validation cohort showed a hazard ratio of 3.8 (95% confidence interval 2.0 to 7.4) comparing osteopontin levels in quartile 4 with quartile 1.

CONCLUSIONS:

Plaque osteopontin levels in single lesions are predictive for cardiovascular events in other vascular territories. Local atherosclerotic plaques are a source of prognostic biomarkers with a high predictive value for secondary manifestations of atherosclerotic disease.

PMID:
20018935
DOI:
10.1161/ATVBAHA.109.194944
[Indexed for MEDLINE]

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