血清富含亮氨酸的α-2糖蛋白1可预测冠状动脉造影患者的10年死亡率和血管事件。

Serum leucine-rich α-2 glycoprotein 1 predicts 10-year mortality and vascular events in coronary angiography patients.

作者信息

Muendlein Axel, Leiherer Andreas, Brandtner Eva Maria, Geiger Kathrin, Heinzle Christine, Gaenger Stella, Schnetzer Laura, Festa Andreas, Saely Christoph H, Drexel Heinz

机构信息

Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria.

Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria; Medical Central Laboratories, Feldkirch, Austria; Private University in the Principality of Liechtenstein, Triesen, Liechtenstein.

出版信息

Atherosclerosis. 2025 Aug;407:120413. doi: 10.1016/j.atherosclerosis.2025.120413. Epub 2025 Jun 20.

DOI:10.1016/j.atherosclerosis.2025.120413

PMID:40577971

Abstract

BACKGROUND AND AIMS

Leucine-rich α-2 glycoprotein 1 (LRG1) is a pro-inflammatory signaling molecule that is highly upregulated in various pathological conditions, including cardiovascular disease. We tested the hypothesis whether LRG1 levels are associated with incident all-cause mortality, vascular mortality, and major adverse cardiovascular events (MACE) in coronary angiography patients.

METHODS

A total of 695 patients referred for elective coronary angiography were included in the study. During a 10-year observational period, the incidence of all-cause mortality, vascular mortality, and MACE was recorded. Serum LRG1 levels were measured using an enzyme-linked immunosorbent assay.

RESULTS

LRG1 showed highly significant correlations with increased age and C-reactive protein, as well as decreased estimated glomerular filtration rate, left ventricular ejection fraction, and triglycerides. LRG1 was higher in females compared to males and was elevated in patients with significant coronary artery disease (CAD) compared to those without CAD. Prospectively, higher LRG1 levels, analyzed in tertiles, significantly predicted incident all-cause mortality, vascular mortality, and MACE, independent of traditional risk factors. Adjusted hazard ratios [95 % confidence intervals] comparing the highest to the lowest tertile were 2.39 [1.58-3.62]; p < 0.001 for all-cause mortality, 2.05 [1.08-3.92]; p = 0.029 for vascular mortality, and 1.80 [1.19-2.75]; p = 0.006 for MACE. C-statistics and net reclassification improvement analyses demonstrated that LRG1 provided additional predictive value for all-cause mortality, beyond conventional risk factors.

CONCLUSIONS

Serum LRG1 is a promising new predictor of all-cause mortality, vascular mortality, and MACE in coronary angiography patients.

摘要

背景与目的

富含亮氨酸的α-2糖蛋白1（LRG1）是一种促炎信号分子，在包括心血管疾病在内的各种病理状况下高度上调。我们检验了LRG1水平是否与接受冠状动脉造影患者的全因死亡率、血管性死亡率及主要不良心血管事件（MACE）相关的假设。

方法

本研究纳入了695例接受择期冠状动脉造影的患者。在10年观察期内，记录全因死亡率、血管性死亡率及MACE的发生率。采用酶联免疫吸附测定法检测血清LRG1水平。

结果

LRG1与年龄增加、C反应蛋白升高以及估算肾小球滤过率降低、左心室射血分数降低和甘油三酯降低显著相关。女性的LRG1水平高于男性，有显著冠状动脉疾病（CAD）患者的LRG1水平高于无CAD患者。前瞻性分析显示，按三分位数分析，较高的LRG1水平可显著预测全因死亡率、血管性死亡率及MACE，且独立于传统危险因素。最高三分位数与最低三分位数相比的校正风险比[95%置信区间]为：全因死亡率2.39[1.58 - 3.62]；p < 0.001；血管性死亡率2.05[1.08 - 3.92]；p = 0.029；MACE为1.80[1.19 - 2.75]；p = 0.006。C统计量和净重新分类改善分析表明，LRG1除了传统危险因素外，还为全因死亡率提供了额外的预测价值。