Dipeptidyl peptidase 3 plasma levels predict cardiogenic shock and mortality in acute coronary syndromes

Area of Science:

• Cardiology
• Biomarkers
• Protease Function

Background:

• Dipeptidyl peptidase 3 (DPP3) is a protease implicated in angiotensin II degradation, affecting blood pressure and cardiac function.
• Its role in acute coronary syndromes (ACS) and associated outcomes like cardiogenic shock (CS) and mortality requires further investigation.

Purpose of the Study:

• To investigate the association between circulating DPP3 (cDPP3) levels and the incidence of CS.
• To evaluate cDPP3 as a predictor of mortality in patients with ACS.

Main Methods:

• Plasma cDPP3 levels were measured at baseline and 12-24 hours post-presentation in 4787 ACS patients from the SPUM-ACS study.
• Statistical analyses, including hazard ratios (HR) and confidence intervals (CI), were used to assess associations with CS and mortality, adjusting for established risk factors and scores (ORBI, GRACE 2.0).

Main Results:

• Elevated cDPP3 levels were significantly associated with in-hospital CS (HR 1.38, P = .021).
• High cDPP3 independently predicted 30-day (HR 1.87, P < .001) and 1-year mortality (HR 1.61, P < .001).
• Persistently elevated cDPP3 at 12-24 hours showed a substantially increased risk for 30-day (HR 13.42) and 1-year mortality (HR 5.79).

Conclusions:

• Circulating DPP3 is identified as a novel biomarker for CS and mortality in ACS patients.
• cDPP3 provides prognostic information that complements existing risk factors, enhancing early risk stratification.