GlycA and hsCRP are independent and additive predictors of future cardiovascular events among patients undergoing angiography: The intermountain heart collaborative study

• Published in: The American heart journal Vol. 202; pp. 27 - 32
• Main Authors: Muhlestein, Joseph B., May, Heidi T., Galenko, Oxana, Knowlton, Kirk U., Otvos, James D., Connelly, Margery A., Lappe, Donald L., Anderson, Jeffrey L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2018; Elsevier Limited
• Subjects: Acetylglucosamine - blood; Age; Aged; Angina pectoris; Angiography; Biomarkers - blood; C-Reactive Protein - analysis; Cardiovascular disease; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - mortality; Categories; Cerebral infarction; Cholesterol; Collaboration; Coronary Angiography; Coronary artery; Coronary artery disease; Coronary Artery Disease - blood; Coronary Artery Disease - diagnostic imaging; Death; Diabetes; Diabetes mellitus; Enzyme-Linked Immunosorbent Assay; Family medical history; Female; Follow-Up Studies; Glucosamine - blood; Glycoproteins - blood; Heart; Heart attacks; Heart diseases; Heart failure; Hospitalization; Humans; Hyperlipidemia; Hypertension; Inflammation; Inflammation - blood; Inflammation - diagnosis; Laboratories; Lipoproteins; Magnetic Resonance Spectroscopy; Male; Medical imaging; Middle Aged; Mortality; Myocardial infarction; NMR; Nuclear magnetic resonance; Patients; Prognosis; Proportional Hazards Models; Quartiles; Renal failure; Risk Assessment - methods; Spectrum analysis; Stroke; United States > US; Utah
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2018.04.003

GlycA is an inflammatory marker that is raised in patients with cardiometabolic diseases and associated with cardiovascular (CV) events. We sought to determine if GlycA adds independent value to hsCRP for CV risk prediction.
Patients in the Intermountain Heart Collaborative Study who underwent coronary angiography and had plasma GlycA and hsCRP levels were studied (n = 2996). Patients were followed for 7.0 ± 2.8 years. GlycA and hsCRP were moderately correlated (r = 0.46, P < .0001). GlycA and hsCRP concentrations were stratified into high and low categories by their median values. Multivariable cox hazard regression was utilized to determine the associations of GlycA quartiles, as well as high and low categories of GlycA and hsCRP, with major adverse cardiovascular events (MACE) defined as the composite of death, myocardial infarction (MI), heart failure (HF) hospitalization, and stroke.
The highest GlycA quartile was associated with future MACE [HR: 1.43; 95% CI: 1.22–1.69; P < .0001]. Patients with high GlycA and high hsCRP had more diabetes, hyperlipidemia, hypertension, HF, renal failure and MI, but not coronary artery disease. High GlycA and hsCRP (H/H) versus low GlycA and hsCRP (L/L) was associated with MACE, death and HF hospitalization, but not MI or stroke. Combined MACE rates were 33.5%, 41.3%, 35.7% and 49.1% for L/L, L/H, H/L and H/H categories of GlycA/hsCRP, respectively (P-trend < .0001). The interaction between GlycA and hsCRP was significant for the outcome of death (P = .03).
In this study, levels of GlycA and hsCRP were independent and additive markers of risk for MACE, death and HF hospitalization.