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Circulating CTRP9 and aortic valve calcification jointly predict coronary artery calcification in coronary heart

Yanru Duan1, Xiaoxue Jin2, Yanan Ma2

  • 1Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.

Frontiers in Nutrition
|May 15, 2026
PubMed

Insights

Lower levels of CTRP9 (C1q/TNF-related protein 9) are linked to increased vascular calcification, specifically aortic valve calcification (AVC) and coronary artery calcification (CAC). CTRP9 shows potential as a biomarker and therapeutic target for these conditions.

Area of Science:

  • Cardiovascular Research
  • Biomarker Discovery
  • Vascular Biology

Background:

  • Vascular calcification is a significant predictor of adverse cardiovascular events.
  • CTRP9, an adiponectin paralog, exhibits known vascular protective properties.
  • Understanding the role of CTRP9 in calcification is crucial for cardiovascular health.

Purpose of the Study:

  • To investigate the association between circulating CTRP9 levels and vascular calcification, including aortic valve calcification (AVC) and coronary artery calcification (CAC).
  • To evaluate CTRP9's predictive capability for severe coronary artery calcification (CAC) and its potential synergy with AVC in risk stratification.
  • To explore the therapeutic potential of CTRP9 in mitigating vascular calcification using an animal model.

Main Methods:

  • A cross-sectional observational study involving 900 coronary heart disease patients.
  • Echocardiography, optical coherence tomography, and serum CTRP9 measurements were performed.
  • Logistic regression, ROC analysis, and ApoE-/- mouse models were utilized to assess CTRP9's role and predictive value.

Main Results:

  • Lower CTRP9 levels were independently associated with more severe AVC and CAC.
  • CTRP9 demonstrated significant predictive power for CAC severity (AUC = 0.74).
  • Combining CTRP9 with AVC measurement improved the prediction of severe CAC (AUC = 0.843), and exogenous CTRP9 attenuated calcification in mice.

Conclusions:

  • Circulating CTRP9 levels are inversely correlated with the severity of vascular calcification.
  • CTRP9 serves as a potential independent biomarker for predicting CAC.
  • The combination of CTRP9 and AVC offers enhanced risk prediction for severe CAC, positioning CTRP9 as a promising therapeutic target.
Abstract

Keywords:
C1q/tumor necrosis factor-related protein 9aortic valve calcificationbiomarkercardiovascular diseasecoronary artery calcification

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