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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
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Plasma ceramides predict cardiovascular death in patients with stable coronary artery disease and acute coronary
Reijo Laaksonen1, Kim Ekroos2, Marko Sysi-Aho2
1Zora Biosciences, Espoo, Finland Medical School, Tampere University, Tampere, Finland Finnish Clinical Biobank Tampere, University Hospital of Tampere, Tampere, Finland reijo.laaksonen@zora.fi.
European Heart Journal
|April 30, 2016
Summary
Plasma ceramides, particularly their ratios, show significant prognostic value for cardiovascular death in coronary artery disease patients. These ceramide markers improve risk prediction beyond traditional lipid profiles, aiding in identifying high-risk individuals.
Area of Science:
- Cardiovascular Medicine
- Biomarker Discovery
- Lipid Metabolism
Background:
- Cardiovascular death remains a leading cause of mortality globally.
- Accurate risk stratification in coronary artery disease (CAD) is crucial for effective patient management.
- Current lipid biomarkers may not fully capture cardiovascular risk.
Purpose of the Study:
- To evaluate the prognostic capability of plasma ceramides (Cer) as markers for cardiovascular death (CV death).
- To assess the predictive value of specific ceramide ratios in independent CAD cohorts.
- To determine if ceramides improve risk prediction beyond established markers.
Main Methods:
- Analysis of plasma ceramides (Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/24:0), Cer(d18:1/24:1)) in three independent cohorts: Corogene (stable CAD, n=160), SPUM-ACS (acute coronary syndromes, n=1637), and BECAC (stable CAD).
- Investigation of associations between high-risk ceramides and CV mortality.
- Validation of ceramide ratios as predictors, independent of other lipid markers and C-reactive protein.
- Assessment of the impact of ceramide ratios on established risk scores (GRACE and Marschner).
Main Results:
- Distinct plasma ceramide ratios, especially Cer(d18:1/16:0)/Cer(d18:1/24:0), were significantly associated with CV death across all three cohorts.
- The Cer(d18:1/16:0)/Cer(d18:1/24:0) ratio demonstrated adjusted odds ratios ranging from 1.64 to 4.49 per standard deviation.
- This ceramide ratio enhanced the predictive value of the GRACE score in ACS patients (net reclassification improvement, NRI = 0.17) and the Marschner score in stable CAD (NRI = 0.15).
Conclusions:
- Specific plasma ceramide ratios are significant predictors of CV death in both stable CAD and acute coronary syndromes (ACS) patients.
- These ceramide markers provide prognostic information independently of traditional lipid markers and C-reactive protein.
- The findings suggest that ceramide ratios can improve the identification of high-risk patients requiring more intensive therapeutic interventions.
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