Distinct Characteristics of VEGF‐D and VEGF‐C to Predict Mortality in Patients With Suspected or Known Coronary Artery Disease

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Akihiro Yasoda¹  Akira Shimatsu¹  Junichi Funada²  Masatoshi Shimizu³  Kazuteru Fujimoto⁴  Toshihiro Nakamura⁵  Hiromi Matsubara⁶  Yukiko Morita⁷  Tsuyoshi Shinozaki⁸  Satoru Sakagami⁹  Masahiro Suzuki^1,10  Toru Kato^1,11  Toru Kusakabe^1,12  Noriko Satoh‐Asahara^1,12  Hajime Yamakage^1,12  Takashi Takenaka^1,13  Kazuya Yonezawa^1,14  Yoichi Ajiro^1,15  Kazuhiko Kotani^1,16  Miyaka Wada^1,17  Moritake Iguchi^1,17  Daisuke Takagi^1,17  Masaharu Akao^1,17  Hiromichi Wada^1,17  Mitsuru Ishii^1,17  Kyohma Wada^1,17  Nobutoyo Masunaga^1,17  Mitsuru Abe^1,17  Koji Hasegawa^1,17  Takashi Unoki^1,17  Morihiro Matsuda^1,18 

[1] Clinical Research Institute National Hospital Organization Kyoto Medical Center Kyoto Japan;Department of Cardiology National Hospital Organization Ehime Medical Center Toon Japan;Department of Cardiology National Hospital Organization Kobe Medical Center Kobe Japan;Department of Cardiology National Hospital Organization Kumamoto Medical Center Kumamoto Japan;Department of Cardiology National Hospital Organization Kyushu Medical Center Fukuoka Japan;Department of Cardiology National Hospital Organization Okayama Medical Center Okayama Japan;Department of Cardiology National Hospital Organization Sagamihara National Hospital Sagamihara Japan;Department of Cardiology National Hospital Organization Sendai Medical Center Sendai Japan;Department of Cardiovascular Medicine National Hospital Organization Kanazawa Medical Center Kanazawa Japan;Department of Clinical Research National Hospital Organization Saitama Hospital Wako Japan;Department of Clinical Research National Hospital Organization Tochigi Medical Center Utsunomiya Japan;Department of Endocrinology, Metabolism, and Hypertension Clinical Research Institute National Hospital Organization Kyoto Medical Center Kyoto Japan;Division of Cardiology National Hospital Organization Hokkaido Medical Center Sapporo Japan;Division of Clinical Research National Hospital Organization Hakodate National Hospital Hakodate Japan;Division of Clinical Research National Hospital Organization Yokohama Medical Center Yokohama Japan;Division of Community and Family Medicine Jichi Medical University Shimotsuke Japan;Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan;Institute for Clinical Research National Hospital Organization Kure Medical Center and Chugoku Cancer Center Kure Japan;

关键词: all‐cause death;    biomarker;    cardiovascular events;    coronary artery disease;    prospective cohort study;   

DOI  :  10.1161/JAHA.119.015761

来源: DOAJ

【 摘 要 】

Background VEGF‐D (vascular endothelial growth factor D) and VEGF‐C are secreted glycoproteins that can induce lymphangiogenesis and angiogenesis. They exhibit structural homology but have differential receptor binding and regulatory mechanisms. We recently demonstrated that the serum VEGF‐C level is inversely and independently associated with all‐cause mortality in patients with suspected or known coronary artery disease. We investigated whether VEGF‐D had distinct relationships with mortality and cardiovascular events in those patients. Methods and Results We performed a multicenter, prospective cohort study of 2418 patients with suspected or known coronary artery disease undergoing elective coronary angiography. The serum level of VEGF‐D was measured. The primary outcome was all‐cause death. The secondary outcomes were cardiovascular death and major adverse cardiovascular events defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. During the 3‐year follow‐up, 254 patients died from any cause, 88 died from cardiovascular disease, and 165 developed major adverse cardiovascular events. After adjustment for possible clinical confounders, cardiovascular biomarkers (N‐terminal pro‐B‐type natriuretic peptide, cardiac troponin‐I, and high‐sensitivity C‐reactive protein), and VEGF‐C, the VEGF‐D level was significantly associated with all‐cause death and cardiovascular death but not with major adverse cardiovascular events.. Moreover, the addition of VEGF‐D, either alone or in combination with VEGF‐C, to the model with possible clinical confounders and cardiovascular biomarkers significantly improved the prediction of all‐cause death but not that of cardiovascular death or major adverse cardiovascular events. Consistent results were observed within patients over 75 years old. Conclusions In patients with suspected or known coronary artery disease undergoing elective coronary angiography, an elevated VEGF‐D value seems to independently predict all‐cause mortality.

【 授权许可】

Unknown