Neopterin as a Predictor of Total and Cardiovascular Mortality in Individuals Undergoing Angiography in the Ludwigshafen Risk and Cardiovascular Health Study

被引：93

作者：

Grammer, Tanja B. ^{[1
,2
]}

Fuchs, Dietmar ^{[3
]}

Boehm, Bernhard O. ^{[4
]}

Winkelmann, Bernhard R. ^{[5
]}

Maerz, Winfried ^{[1
,2
,6
]}

机构：

[1] Synlab Ctr Lab Diagnost Heidelberg, D-69037 Heidelberg, Germany

[2] Med Univ Graz, Clin Inst Med & Chem Lab Diagnost, Graz, Austria

[3] Med Univ Innsbruck, Div Biol Chem, Bioctr, Innsbruck, Austria

[4] Univ Ulm, Div Endocrinol, Dept Med, D-89069 Ulm, Germany

[5] Cardiol Grp Frankfurt Sachsenhausen, Frankfurt, Germany

[6] Heidelberg Univ, Dept Publ Hlth Social & Prevent Med, Mannheim Med Fac, D-6800 Mannheim, Germany

来源：

CLINICAL CHEMISTRY | 2009年 / 55卷 / 06期

关键词：

INFLUENCING SERUM NEOPTERIN; CELLULAR IMMUNE ACTIVATION; ADVERSE CARDIAC EVENTS; DISEASE PROGRESSION; MARKERS; SYSTEM; DEGRADATION; TRYPTOPHAN;

D O I：

10.1373/clinchem.2008.118844

中图分类号：

R446 [实验室诊断]; R-33 [实验医学、医学实验];

学科分类号：

1001 ;

摘要：

BACKGROUND: Neopterin is produced upon activation of the cell-mediated immune response, and may be a novel risk marker for adverse outcomes resulting from coronary artery disease. METHODS: We measured neopterin in 1801 study participants with and 511 without angiographic coronary artery disease. Rates of death were determined after a median follow-up of 8.0 years. RESULTS: Estimated glomerular filtration rate and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were the strongest predictors of neopterin. Neopterin was positively related to age and inversely related to LDL cholesterol, HDL cholesterol, and triglycerides. Use of lipid-lowering drugs lowered neopterin. Sex, body mass index, diabetes mellitus, hypertension, smoking status, Friesinger coronary score, and clinical instability at presentation were not associated with neopterin. Unlike C-reactive protein, neopterin was not increased in unstable angina pectoris, non-ST-elevation myocardial infarction, or ST-elevation myocardial infarction. In the third and fourth quartiles of neopterin, unadjusted hazard ratios for death from any cause were 1.94 (95% CI 1.44-2.61) and 3.32 (95% CI 2.53-4.30) compared to individuals in the first quartile, whereas hazard ratios for death from cardiovascular causes were 2.14 (95% CI 1.44-3.18) and 3.84 (95% CI 2.67-5.52), respectively. Neopterin remained predictive of total and cardiovascular mortality after adjusting for sex, age, body mass index, type 2 diabetes, hypertension, smoking status, LDL cholesterol, HDL cholesterol, triglycerides, estimated glomerular filtration rate, NT-proBNP, and clinical status at presentation, but NT-proBNP substantially weakened this association. CONCLUSIONS: Neopterin is an independent predictor of all-cause and cardiovascular mortality in individuals with or without stable coronary artery disease. (C) 2009 American Association for Clinical Chemistry

引用

页码：1135 / 1146

页数：12

共 36 条

[1] Urinary neopterin excretion and dihydropteridine reductase activity in rheumatoid arthritis [J].