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Circulating surfactant protein-D and the risk of cardiovascular morbidity and mortality
John Hill1, Claire Heslop, S F Paul Man
1Providence Heart and Lung Institute and The UBC James Hogg Research Center, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6.
Insights
Surfactant protein-D (SP-D) is a lung protein detectable in plasma. Higher SP-D levels predict cardiovascular disease (CVD) mortality, adding value to existing risk factors.
Area of Science:
- Pulmonary Medicine
- Cardiovascular Medicine
- Biomarker Discovery
Background:
- Surfactant protein-D (SP-D) is a lung-specific protein found in human plasma.
- Its role in cardiovascular disease (CVD) and mortality is not fully understood.
Purpose of the Study:
- To investigate the relationship between circulating SP-D levels and cardiovascular morbidity and mortality.
- To assess SP-D as a potential biomarker linking lung inflammation to CVD.
Main Methods:
- Plasma SP-D levels were measured in 806 patients undergoing coronary angiography.
- Serum SP-D levels were analyzed in a cohort of 4468 smokers without prior coronary artery disease (CAD).
Main Results:
- Higher SP-D levels were significantly associated with increased cardiovascular mortality in the angiography cohort.
- Elevated SP-D levels were observed in smokers who experienced CVD events or death.
- SP-D independently predicted CVD mortality, outperforming traditional risk factors.
Conclusions:
- Circulating SP-D is a significant predictor of cardiovascular morbidity and mortality.
- SP-D offers valuable prognostic information beyond established risk factors like age, sex, and lipids.
- SP-D shows promise as a biomarker connecting lung inflammation/injury to CVD.
Aims:
Surfactant protein-D (SP-D) is a lung-specific protein that is detectable in human plasma. We determined the relationship of circulating SP-D to cardiovascular disease (CVD) and total mortality in subjects with and without CVD.
Methods And Results:
Plasma SP-D levels were measured in 806 patients who underwent coronary angiography to assess its predictive value for cardiovascular mortality. Serum SP-D levels were also measured in a replication cohort to assess its relationship with CVD events in 4468 ex- and current smokers without a known history of coronary artery disease (CAD). Patients who died during follow-up had significantly higher plasma SP-D levels than those who survived (median 85.4 vs. 64.8 ng/mL; P < 0.0001). Those in the highest quintile of SP-D had 4.4-fold higher risk of CVD mortality than those in the lowest quintile (P < 0.0001) independent of age, sex, and plasma lipid levels. In a group of current and ex-smokers without a known history of CAD, serum SP-D levels were elevated in those who died or were hospitalized for CVD compared with those who did not (median 99.8 vs. 90.6 ng/mL; P = 0.0001).
Conclusion:
Circulating SP-D is a good predictor of cardiovascular morbidity and mortality and adds prognostic information to well-established risk factors such as age, sex, and plasma lipids and is a promising biomarker to link lung inflammation/injury to CVD.
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