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

DPV de Kleijn, FL Moll, WE Hellings… - … , and vascular biology, 2010 - Am Heart Assoc
DPV de Kleijn, FL Moll, WE Hellings, G Ozsarlak-Sozer, P de Bruin, PA Doevendans, A Vink…
Arteriosclerosis, thrombosis, and vascular biology, 2010Am Heart Assoc
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 …
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.
Conclusion— 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.
Am Heart Assoc