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Prognostic Impact of Soluble P-Selectin on Long-Term Adverse Cardiovascular Outcomes in Patients Undergoing
Maximilian Tscharre1,2, Birgit Vogel1,3, Ioannis Tentzeris1
13rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenspital, Vienna, Austria.
Insights
Elevated soluble P-selectin (sP-selectin) levels indicate a higher risk of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI). This finding highlights sP-selectin as a potential biomarker for long-term cardiovascular outcomes in stented patients.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Inflammation Research
Background:
- Soluble P-selectin (sP-selectin) is an inflammatory biomarker linked to cardiovascular disease.
- sP-selectin promotes atherosclerosis by increasing leukocyte recruitment and influencing thrombosis.
Purpose of the Study:
- To investigate the association between sP-selectin levels and long-term major adverse cardiovascular events (MACE).
- To assess the predictive value of sP-selectin in patients following coronary stenting for coronary artery disease.
Main Methods:
- Analysis of 733 patients undergoing percutaneous coronary intervention (PCI) between 2003-2006.
- Plasma sP-selectin concentrations measured via enzyme-linked immunoassay.
- Patients stratified into sP-selectin quartiles; long-term MACE (death, myocardial infarction, stroke) as the primary endpoint.
Main Results:
- After a mean follow-up of 9.7 years, 46.9% of patients experienced MACE.
- Higher sP-selectin quartiles (2nd, 3rd, 4th) were significantly associated with increased MACE risk compared to the 1st quartile (p<0.05).
- Elevated sP-selectin as a continuous variable independently predicted MACE (HR 1.009 per 1 ng/mL increase, p=0.016).
Conclusions:
- Increased sP-selectin levels are linked to a higher risk of long-term MACE in patients who have undergone PCI.
- sP-selectin may serve as a valuable prognostic biomarker in post-PCI patients.
- These findings underscore the role of inflammation in cardiovascular events after stenting.
Background:
Soluble P-selectin (sP-selectin), a biomarker of inflammatory pathologies including cardiovascular disease, is known to have pro-atherosclerotic effects such as the ability to increase leukocyte recruitment and modulate thrombotic response. We aimed to assess the impact of sP-selectin on long-term major adverse cardiovascular events (MACE) in patients after coronary stenting for coronary artery disease.
Methods:
We analysed 733 patients of a single-centre registry undergoing percutaneous coronary intervention (PCI) between 2003 and 2006. Plasma samples were analysed for sP-selectin antigen concentration with an enzyme-linked immunoassay. The study population was categorized according to sP-selectin quartiles. Endpoint of the study was long-term MACE, a composite of all-cause death, myocardial infarction (MI) and stroke.
Results:
Of the total patient cohort, 361 (49.2%) patients were admitted for stable coronary artery disease and 372 (50.8%) for acute coronary syndrome. Median age was 64 years and 70.7% were male. After a mean follow-up period of 9.7 years, MACE occurred in 344 (46.9%) patients. The primary endpoint components of all-cause death occurred in 211 (28.8%), MI in 88 (12.0%) and ischaemic stroke in 45 (6.1%) patients. After adjustment for confounders, patients in the 2nd, 3rd and 4th quartile were at higher risk for MACE compared with the 1st quartile (hazard ration [HR], 1.234 [0.899-1.695], p = 0.193; HR, 1.480 [1.085-2.019], p = 0.013; and HR, 1.571 [1.115-2.152], p = 0.004). sP-selectin as continuous variable model was significantly associated with MACE after adjustment (HR per 1 ng/mL increase of 1.009 [95% confidence interval, 1.002-1.017]; p = 0.016).
Conclusion:
Elevated levels of sP-selectin were associated with increased risk for long-term MACE in patients undergoing PCI.
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