Complement component 7 is associated with total- and cardiac death in chest-pain patients with suspected acute
Reidun Aarsetøy1,2, Thor Ueland3, Pål Aukrust3,4
1Department of Clinical Science, University of Bergen, Bergen, Norway. Reidun.Aarsetoy@uib.no.
Insights
Complement component 7 (CC7) predicts mortality in patients with suspected acute coronary syndrome (ACS). Higher CC7 levels are linked to increased risks of all-cause and cardiac death within 60 months.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Biomarker Research
Background:
- Complement activation is implicated in atherosclerosis and cardiovascular events.
- Complement component 7 (CC7) is part of the terminal complement complex.
- High-sensitivity C-reactive protein (hsCRP) indicates systemic inflammation in cardiovascular disease.
Purpose of the Study:
- To assess the association between CC7 and mortality in patients hospitalized with chest pain.
- To determine if combining CC7 with hsCRP improves prognostic information.
Main Methods:
- Prospective observational study of 982 patients with suspected acute coronary syndrome (ACS).
- Cox regression analysis adjusted for cardiovascular risk factors to predict all-cause mortality, cardiac death, and sudden cardiac death (SCD).
- Reproducibility tested in a Norwegian cohort of 871 patients.
Main Results:
- CC7 was significantly associated with 60-month all-cause mortality (HR 1.26) and cardiac death (HR 1.28).
- No significant association was found between CC7 and SCD.
- CC7 showed weak correlation with hsCRP, with no significant interaction for outcomes.
Conclusions:
- CC7 is a significant predictor of all-cause and cardiac mortality in patients with suspected ACS.
- The prognostic value of CC7 was confirmed in an independent Norwegian cohort.
- CC7 may serve as a valuable prognostic biomarker in cardiovascular disease management.
Background:
Complement activation has been associated with atherosclerosis, atherosclerotic plaque destabilization and increased risk of cardiovascular events. Complement component 7 (CC7) binds to the C5bC6 complex which is part of the terminal complement complex (TCC/C5b-9). High-sensitivity C-reactive protein (hsCRP) is a sensitive marker of systemic inflammation and may reflect the increased inflammatory state associated with cardiovascular disease.
Aim:
To evaluate the associations between CC7 and total- and cardiac mortality in patients hospitalized with chest-pain of suspected coronary origin, and whether combining CC7 with hsCRP adds prognostic information.
Methods:
Baseline levels of CC7 were related to 60-months survival in a prospective, observational study of 982 patients hospitalized with a suspected acute coronary syndrome (ACS) at 9 hospitals in Salta, Argentina. A cox regression model, adjusting for conventional cardiovascular risk factors, was fitted with all-cause mortality, cardiac death and sudden cardiac death (SCD) as the dependent variables. A similar Norwegian population of 871 patients was applied to test the reproducibility of results in relation to total death.
Results:
At follow-up, 173 patients (17.7%) in the Argentinean cohort had died, of these 92 (9.4%) were classified as cardiac death and 59 (6.0%) as SCD. In the Norwegian population, a total of 254 patients (30%) died. In multivariable analysis, CC7 was significantly associated with 60-months all-cause mortality [hazard ratio (HR) 1.26 (95% confidence interval (CI), 1.07-1.47) and cardiac death [HR 1.28 (95% CI 1.02-1.60)], but not with SCD. CC7 was only weakly correlated with hsCRP (r = 0.10, p = 0.002), and there was no statistically significant interaction between the two biomarkers in relation to outcome. The significant association of CC7 with total death was reproduced in the Norwegian population.
Conclusions:
CC7 was significantly associated with all-cause mortality and cardiac death at 60-months follow-up in chest-pain patients with suspected ACS.
Clinical Trial Registration:
ClinicalTrials.gov Identifier: NCT01377402, NCT00521976.
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