Matrix Gla Protein, Plaque Stability, and Cardiovascular Events in Patients with Severe Atherosclerotic Disease

Cardiology - Tập 141 Số 1 - Trang 32-36 - 2018
Sabine R. Zwakenberg1, Yvonne T. van der Schouw1, Cees Vermeer2, Gerard Pasterkamp3, Hester M. den Ruijter3, Joline W. J. Beulens4,1
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
2R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
3Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
4Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands

Tóm tắt

<b><i>Objective:</i></b> This study aims to investigate whether plasma matrix Gla protein (MGP) species, desphospho-uncarboxylated (dp-uc) MGP, and total uncarboxylated (t-uc) MGP are associated with plaque levels of uncarboxylated (uc) MGP, markers of plaque stability, and cardiovascular disease (CVD) risk. <b><i>Methods:</i></b> From the Athero-Express biobank, we selected carotid plaque samples of 100 patients who underwent carotid endarterectomy. The level of agreement between plasma MGP species and plaque ucMGP levels was assessed using weighted kappa (κ). We analyzed histological characteristics of plaque composition (plaque hemorrhage, lipid and calcification content). Logistic regression analyses were used to assess the association between plasma MGP and plaque characteristics. Furthermore, CVD endpoints (<i>n</i> = 20) were collected over a mean follow-up of 2.6 years. <b><i>Results:</i></b> Weighted κ statistics of plasma dp-ucMGP and t-ucMGP and plaque ucMGP were 0.10 (95% CI –0.31 to 0.52) and 0.14 (95% CI –0.20 to 0.48). Higher dp-ucMGP levels tended to be associated with less plaque hemorrhage (OR<sub>per 500 nM</sub> 0.96; 95% CI 0.92–1.00). No association was found for lipid and calcification content. Cox proportional hazards models showed no association between dp-ucMGP (HR<sub>per 200 pM</sub> 0.92; 95% CI 0.75–1.11) and an inverse association between t-ucMGP (HR<sub>per 500 nM</sub> 0.79; 95% CI 0.62–0.99) and cardiovascular events. <b><i>Conclusions:</i></b> Plasma dp-ucMGP and t-ucMGP concentrations do not reflect plaque ucMGP levels. Elevated dp-ucMGP levels may be associated with less plaque hemorrhage, suggestive of more stable plaques. T-ucMGP was not related with markers of plaque stability; however, elevated plasma t-ucMGP levels were associated with a reduced CVD risk.

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Cardiology

Tập 141 Số 1

32-36

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