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J Am Heart Assoc. 2017 Feb 3;6(2). pii: e003620. doi: 10.1161/JAHA.116.003620.

Serum Acylcarnitines and Risk of Cardiovascular Death and Acute Myocardial Infarction in Patients With Stable Angina Pectoris.

Author information

1
Department of Clinical Science, University of Bergen, Norway elin.strand@uib.no.
2
Department of Clinical Science, University of Bergen, Norway.
3
Department of Nutrition, University of Oslo, Norway.
4
Department of Clinical Medicine, University of Bergen, Norway.
5
KG Jebsen Center for Diabetes Research, University of Bergen, Norway.
6
Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
7
Hormone Laboratory, Haukeland University Hospital, Bergen, Norway.
8
Department of Global Public Health and Primary Care, University of Bergen, Norway.
9
Division for Health Data and Digitalisation, Norwegian Institute of Public Health, Bergen, Norway.
10
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.

Abstract

BACKGROUND:

Excess levels of serum acylcarnitines, which are intermediate products in metabolism, have been observed in metabolic diseases such as type 2 diabetes mellitus. However, it is not known whether acylcarnitines may prospectively predict risk of cardiovascular death or acute myocardial infarction in patients with stable angina pectoris.

METHODS AND RESULTS:

This study included 4164 patients (median age, 62 years; 72% men). Baseline serum acetyl-, octanoyl-, palmitoyl-, propionyl-, and (iso)valerylcarnitine were measured using liquid chromatography/tandem mass spectrometry. Hazard ratios (HRs) and 95% CIs for quartile 4 versus quartile 1 are reported. The multivariable model included age, sex, body mass index, fasting status, current smoking, diabetes mellitus, apolipoprotein A1, apolipoprotein B, creatinine, left ventricular ejection fraction, extent of coronary artery disease, study center, and intervention with folic acid or vitamin B6. During median 10.2 years of follow-up, 10.0% of the patients died of cardiovascular disease and 12.8% suffered a fatal or nonfatal acute myocardial infarction. Higher levels of the even-chained acetyl-, octanoyl-, and palmitoyl-carnitines were significantly associated with elevated risk of cardiovascular death, also after multivariable adjustments (HR [95% CI]: 1.52 [1.12, 2.06]; P=0.007; 1.73 [1.23, 2.44]; P=0.002; and 1.61 [1.18, 2.21]; P=0.003, respectively), whereas their associations with acute myocardial infarction were less consistent.

CONCLUSIONS:

Among patients with suspected stable angina pectoris, elevated serum even-chained acylcarnitines were associated with increased risk of cardiovascular death and, to a lesser degree with acute myocardial infarction, independent of traditional risk factors.

CLINICAL TRIAL REGISTRATION:

URL: http://www.clinicaltrials.gov. Unique identifier: NCT00354081.

KEYWORDS:

acylcarnitines; angina pectoris; cardiovascular outcomes; metabolism

PMID:
28159823
PMCID:
PMC5523736
DOI:
10.1161/JAHA.116.003620
[Indexed for MEDLINE]
Free PMC Article

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