Published Online
on December 15, 2008

A more recent version of this article appeared on February 1, 2009

This Article Full Text (PDF) All Versions of this Article: 2/1/14    most recent CIRCINTERVENTIONS.108.795799v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Derer, W. Articles by Dechend, R. Search for Related Content PubMed Articles by Derer, W. Articles by Dechend, R. Related Collections Primary prevention Ischemic biology - basic studies Related Article

Original Article

Vitronectin concentrations predict risk in patients undergoing coronary stenting

Wolfgang Derer¹; Elliot S. Barnathan²; Erdal Safak¹; Prasheen Agarwal²; Harald Heidecke³; Martin Möckel¹; Michael Gross¹; Cemil Oezcelik¹; Rainer Dietz¹ and Ralf Dechend^1,4

¹ Charité, Berlin, Germany;
² Centocor Research & Development, Inc., Malvern, PA;
³ CellTrend, Luckenwalde, Germany

⁴ E-mail: ralf.dechend{at}charite.de

Background—Vitronectin is a multifunctional protein with a multiple binding domain that interacts with a variety of plasma and cell proteins. Vitronectin binds multiple ligands, including the soluble vitronectin receptor (sVNR). Abciximab binds equally well to sVNR and glycoprotein IIb/IIIa, as both share the β₃ subunit. We tested whether vitronectin concentrations correlate with adverse outcomes in acute coronary syndrome patients.

Methods and Results—Baseline serum samples (n=233) from a randomized, placebo-controlled trial of abciximab plus stenting (EPISTENT) were retrospectively analyzed. We stratified vitronectin concentrations into the three lower quartiles (n=178; <49.7 µg/ml) versus the fourth upper quartile (n=55; 49.7 µg/ml). The endpoint was major adverse cardiovascular event (MACE) defined as death, MI or urgent revascularization at 30 days and 6 months. A higher proportion of patients with baseline vitronectin 49.7 µg/ml had MACE than patients with baseline vitronectin <49.7 µg/ml at 30 days (18.2% vs. 5.6%; p=0.01) and 6 months (20.0% vs. 6.2%; p=0.006). When baseline variables not predictive of MACE (e.g., troponin positive, history congestive heart failure, diabetes, history of hypertension, smoking status) were excluded from the multivariate model, only baseline vitronectin 49.7 µg/ml (at 30 days: OR 3.23; 95% CI 1.23, 8.49; at 6 months: OR 3.36; 95% CI 1.33, 8.52) and history of myocardial infarction (at 30 days: OR 5.02; 95% CI 1.41, 17.9; at 6 months: OR 3.99; 95% CI 1.28, 12.43) remained. No interaction occurred between abciximab and vitronectin.

Conclusions—Our findings indicate that vitronectin may be an independent predictor of adverse cardiovascular outcomes following acute stenting.

Key Words: glycoproteins • risk factors • stents • vitronectin

Related Article

Advancing Biomarker Science in the 21st Century

Richard C. Becker
Circ Cardiovasc Interv 2009 2: 4-5. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				R. C. Becker Advancing Biomarker Science in the 21st Century Circ Cardiovasc Interv, February 1, 2009; 2(1): 4 - 5. [Full Text] [PDF]