Desphospho-uncarboxylated matrix Gla-protein is associated with mortality risk in patients with chronic stable vascular disease
Language English Country Ireland Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
24835435
DOI
10.1016/j.atherosclerosis.2014.04.027
PII: S0021-9150(14)00227-5
Knihovny.cz E-resources
- Keywords
- Coronary heart disease, Dp-cMGP, Dp-ucMGP, EUROASPIRE, Matrix Gla-protein, Mortality, Secondary prevention, Stroke,
- MeSH
- Biomarkers blood MeSH
- Stroke blood mortality MeSH
- Enzyme-Linked Immunosorbent Assay MeSH
- Extracellular Matrix Proteins blood chemistry MeSH
- Myocardial Infarction blood mortality MeSH
- Myocardial Ischemia blood mortality MeSH
- Kaplan-Meier Estimate MeSH
- Cardiovascular Diseases blood diagnosis MeSH
- Middle Aged MeSH
- Humans MeSH
- Matrix Gla Protein MeSH
- Vascular Diseases blood mortality MeSH
- Proportional Hazards Models MeSH
- Prospective Studies MeSH
- Calcium-Binding Proteins blood chemistry MeSH
- Regression Analysis MeSH
- Myocardial Revascularization mortality MeSH
- Aged MeSH
- Vitamin K metabolism MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Biomarkers MeSH
- Extracellular Matrix Proteins MeSH
- Calcium-Binding Proteins MeSH
- Vitamin K MeSH
BACKGROUND: Vitamin K is the essential co-factor for activation of matrix Gla-protein (MGP), the natural inhibitor of tissue calcification. Biologically inactive, desphospho-uncarboxylated MGP (dp-ucMGP) is a marker of vascular vitamin K status and is described to predict mortality in patients with heart failure and aortic stenosis. We hypothesized that increased dp-ucMGP might be associated with mortality risk in clinically stable patients with chronic vascular disease. MATERIALS AND METHODS: We examined 799 patients (mean age 65.1 ± 9.3 years) who suffered from myocardial infarction, coronary revascularization or first ischemic stroke (pooled Czech samples of EUROASPIRE III and EUROASPIRE-stroke surveys), and followed them in a prospective cohort study. To estimate the 5-year all-cause and cardiovascular mortality we ascertained vital status and declared cause of death. Circulating dp-ucMGP and desphospho-carboxylated MGP (dp-cMGP) were measured by ELISA methods (IDS and VitaK). RESULTS: During a median follow-up of 2050 days (5.6 years) 159 patients died. In the fully adjusted multivariate Cox proportional hazard model, the patients in the highest quartile of dp-ucMGP (≥ 977 pmol/L) had higher risk of all-cause and cardiovascular 5-year mortality [HRR 1.89 (95% CI, 1.32-2.72) and 1.88 (95% CI, 1.22-2.90)], respectively. Corresponding HRR for dp-cMGP were 1.76 (95% CI, 1.18-2.61) and 1.79 (95% CI, 1.12-2.57). CONCLUSIONS: In patients with overt vascular disease, circulating dp-ucMGP and dp-cMGP were independently associated with the risk of all-cause and cardiovascular mortality. Since published results are conflicting regarding the dp-cMGP, we propose only circulating dp-ucMGP as a potential biomarker for assessment of additive cardiovascular risk.
Department of Neurology University Hospital Pilsen Czech Republic
VitaK Cardiovascular Research Institute Maastricht Maastricht University The Netherlands
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