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14-07-2011 | Cardiometabolic | Article

LBP is potential risk marker for CAD

Abstract

Free abstract

MedWire News: High levels of lipopolysaccharide-binding protein (LBP) are associated with increased total and cardiovascular (CV) mortality in individuals with or without stable coronary artery disease (CAD), suggests an analysis of the LURIC study.

In a previous investigation, Winfried März (University of Heidelberg, Mannheim, Germany) and colleagues found a positive association between LBP and CAD in men.

To explore the role of LBP in CAD further, the team measured LBP levels in nearly 3000 male and female participants of the LURIC (Ludwigshafen Risk and Cardiovascular Health) cohort, who had undergone coronary angiography between 1997 and 2000. The researchers performed a follow-up analysis over a median period of 8 years, with primary and secondary endpoints of CV mortality and all-cause mortality, respectively.

Overall, the researchers observed 686 all-cause deaths and 432 deaths attributable to CV disorders during follow-up.

LBP was a significant and independent predictor of total and CV mortality after adjusting for established CV risk factors and markers of inflammation, reports the team. Indeed, individuals in the highest quartile of LBP (≥8.53 µg/ml) were at a 43% increased risk for total mortality and a 55% increased risk for CV mortality, compared with those in the lowest quartile (≤5.35 µg/ml).

In addition, März and team say that LBP levels were significantly higher in patients with angiographically proven CAD (n=2298) compared with those free from CAD (n=661), at 6.78 versus 6.13 µg/ml, respectively.

Moreover, LBP levels increased according to CAD severity; median LBP levels for patients with one, two, or three vessels with stenoses greater than 50% were 6.71, 6.60, and 7.02 µg/ml, respectively, compared with 6.29 µg/ml for patients with less than 50% stenosis.

Of note, although LBP quartiles were associated with the prevalence of CAD, LBP did not give additional information on the prevalence of CAD compared with high-sensitivity C-reactive protein, indicating that these two markers may give similar information on CAD, say März et al.

"Given that significant evidence has accumulated indicating that inflammation plays a pivotal role in all stages of atherosclerosis, we believe evidence from the present study supports the concept that LBP is linked to CAD," comment the researchers in the journal Atherosclerosis.

"We propose LBP as a novel risk factor for CV and possibly other causes of death," they conclude.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Nikki Withers