Predicting the risk of death in patients with known coronary artery disease

The extent of anatomic coronary artery disease, along with age and the presence of diabetes, is a strong predictor of subsequent death due to any cause and due to coronary artery disease (CAD).

However, there is currently interest in whether measuring blood levels of markers of low-grade inflammation, such as C-reactive protein (CPR), interleukin-6 (IL-6) and serum amyloid A (SAA) protein, can help in identifying patients at risk of CAD and in improving prognostic estimates.

In this study of over 1000 patients who underwent coronary angiograms and were followed for an average of 8.5 years, several biomarkers emerged as potentially clinically useful. Increases in the risk of death were associated with increasing levels of plasma CPR, IL-6, SAA and total homocysteine (tHcy).

The researchers found that in the presence of known CAD, IL-6 and tHcy were the strongest independent markers of subsequent CAD-related and all-cause death.

In an accompanying editorial commentary, Gordon Lowe of the University of Glasgow evaluates these findings in light of the current hypothesis that inflammatory markers and homocysteine play a causal role in CAD, and he argues that there is as yet insufficient evidence to support their use in routine cardiovascular risk assessment.

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p. 461 Relative value of multiple plasma biomarkers as risk factors for coronary artery disease and death in an angiography cohort -- K.W.J. Lee et al
http://www.cmaj.ca/pressrelease/pg461.pdf

p. 479 The association between elevated levels of inflammation biomarkers and coronary artery disease and death -- G.D.O. Lowe
http://www.cmaj.ca/pressrelease/pg479.pdf


Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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