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European Heart Journal Advance Access originally published online on November 2, 2007
European Heart Journal 2007 28(24):3006-3011; doi:10.1093/eurheartj/ehm488
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

Plasma angiogenin levels in acute coronary syndromes: implications for prognosis

Antonio Tello-Montoliu1,2, Francisco Marín1, Jeetesh Patel2, Vanessa Roldán3, Luis Mainar4, Vicente Vicente3, Francisco Sogorb1 and Gregory Y.H. Lip2,*

1 Cardiology Department, Hospital General Universitario, Alicante, Spain
2 Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Dudley Road, Birmingham B18 7QH, UK
3 Hematology and Oncology Department, Hospital Morales Meseguer, Murcia, Spain
4 Cardiology Unit, Hospital de Requena, Valencia, Spain

Received 14 May 2007; revised 15 September 2007; accepted 28 September 2007; online publish-ahead-of-print 2 November 2007.

* Corresponding author. Tel: +44 121 507 5080; fax: +44 1722 323159/+44 121 554 4083. E-mail address: g.y.h.lip{at}bham.ac.uk

Aims: Angiogenin is a member of the ribonuclease superfamily, which has been implicated as a mitogen of endothelial cells and activator of matrix metalloproteinases and plasminogen-activated plasmin pathways. We hypothesized abnormalities of angiogenin levels in acute coronary syndrome (ACS), with prognostic implications for predicting adverse events.

Methods and results: We measured plasma angiogenin levels (ELISA) in 396 consecutive patients (63.4% males; mean age 67 years, SD 13) admitted with ACS, who were compared with 44 ‘disease controls’ (patients with stable coronary artery disease) and 76 healthy controls. Clinical follow-up at 6 months was performed for adverse endpoints (cardiovascular death, recurrent ACS, revascularization and heart failure). ACS patients had significantly elevated plasma angiogenin levels compared with both disease controls and healthy controls (P < 0.001). After adjusting for baseline characteristics, raised troponin T levels and electrocardiographic changes, raised angiogenin levels were independently associated with more adverse events at 6 months’ follow-up [HR 1.44 (95% CI: 1.10–1.89); P = 0.008].

Conclusion: Plasma angiogenin levels are significantly increased in ACS, and may be involved in the pathogenesis of this condition. High angiogenin levels were predictive of adverse events during follow-up.

Key Words: Angiogenin • Acute coronary syndrome • Prognosis


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