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Serum amyloid A as a predictor of coronary artery disease and cardiovascular outcome in women: the National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation (WISE).
Circulation 2004; 109(6):726-32Circ

Abstract

BACKGROUND

Serum amyloid-alpha (SAA) is a sensitive marker of an acute inflammatory state. Like high-sensitivity C-reactive protein (hs-CRP), SAA has been linked to atherosclerosis. However, prior studies have yielded inconsistent results, and the independent predictive value of SAA for coronary artery disease (CAD) severity and cardiovascular events remains unclear.

METHODS AND RESULTS

A total of 705 women referred for coronary angiography for suspected myocardial ischemia underwent plasma assays for SAA and hs-CRP, quantitative angiographic assessment, and follow-up evaluation. Cardiovascular events were death, myocardial infarction, congestive heart failure, stroke, and other vascular events. The women's mean age was 58 years (range 21 to 86 years), and 18% were nonwhite. SAA and hs-CRP were associated with a broad range of CAD risk factors. After adjustment for these risk factors, SAA levels were independently but moderately associated with angiographic CAD (P=0.004 to 0.04) and highly predictive of 3-year cardiovascular events (P<0.0001). By comparison, hs-CRP was not associated with angiographic CAD (P=0.08 to 0.35) but, like SAA, was strongly and independently predictive of adverse cardiovascular outcome (P<0.0001).

CONCLUSIONS

Our results show a strong independent relationship between SAA and future cardiovascular events, similar to that found for hs-CRP. Although SAA was independently but moderately associated with angiographic CAD, this association was not found for hs-CRP. These results are consistent with the hypothesis that systemic inflammation, manifested by high SAA or hs-CRP levels, may promote atherosclerotic plaque destabilization, in addition to exerting a possible direct effect on atherogenesis.

Authors+Show Affiliations

Graduate School of Public Health, University of Pittsburgh, Parran 127, 130 DeSoto St, Pittsburgh, PA 15261, USA. djohnson@edc.pitt.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14970107

Citation

Johnson, B Delia, et al. "Serum Amyloid a as a Predictor of Coronary Artery Disease and Cardiovascular Outcome in Women: the National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation (WISE)." Circulation, vol. 109, no. 6, 2004, pp. 726-32.
Johnson BD, Kip KE, Marroquin OC, et al. Serum amyloid A as a predictor of coronary artery disease and cardiovascular outcome in women: the National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation (WISE). Circulation. 2004;109(6):726-32.
Johnson, B. D., Kip, K. E., Marroquin, O. C., Ridker, P. M., Kelsey, S. F., Shaw, L. J., ... Reis, S. E. (2004). Serum amyloid A as a predictor of coronary artery disease and cardiovascular outcome in women: the National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation (WISE). Circulation, 109(6), pp. 726-32.
Johnson BD, et al. Serum Amyloid a as a Predictor of Coronary Artery Disease and Cardiovascular Outcome in Women: the National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation (WISE). Circulation. 2004 Feb 17;109(6):726-32. PubMed PMID: 14970107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum amyloid A as a predictor of coronary artery disease and cardiovascular outcome in women: the National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation (WISE). AU - Johnson,B Delia, AU - Kip,Kevin E, AU - Marroquin,Oscar C, AU - Ridker,Paul M, AU - Kelsey,Sheryl F, AU - Shaw,Leslee J, AU - Pepine,Carl J, AU - Sharaf,Barry, AU - Bairey Merz,C Noel, AU - Sopko,George, AU - Olson,Marian B, AU - Reis,Steven E, AU - ,, PY - 2004/2/19/pubmed PY - 2004/5/12/medline PY - 2004/2/19/entrez SP - 726 EP - 32 JF - Circulation JO - Circulation VL - 109 IS - 6 N2 - BACKGROUND: Serum amyloid-alpha (SAA) is a sensitive marker of an acute inflammatory state. Like high-sensitivity C-reactive protein (hs-CRP), SAA has been linked to atherosclerosis. However, prior studies have yielded inconsistent results, and the independent predictive value of SAA for coronary artery disease (CAD) severity and cardiovascular events remains unclear. METHODS AND RESULTS: A total of 705 women referred for coronary angiography for suspected myocardial ischemia underwent plasma assays for SAA and hs-CRP, quantitative angiographic assessment, and follow-up evaluation. Cardiovascular events were death, myocardial infarction, congestive heart failure, stroke, and other vascular events. The women's mean age was 58 years (range 21 to 86 years), and 18% were nonwhite. SAA and hs-CRP were associated with a broad range of CAD risk factors. After adjustment for these risk factors, SAA levels were independently but moderately associated with angiographic CAD (P=0.004 to 0.04) and highly predictive of 3-year cardiovascular events (P<0.0001). By comparison, hs-CRP was not associated with angiographic CAD (P=0.08 to 0.35) but, like SAA, was strongly and independently predictive of adverse cardiovascular outcome (P<0.0001). CONCLUSIONS: Our results show a strong independent relationship between SAA and future cardiovascular events, similar to that found for hs-CRP. Although SAA was independently but moderately associated with angiographic CAD, this association was not found for hs-CRP. These results are consistent with the hypothesis that systemic inflammation, manifested by high SAA or hs-CRP levels, may promote atherosclerotic plaque destabilization, in addition to exerting a possible direct effect on atherogenesis. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/14970107/Serum_amyloid_A_as_a_predictor_of_coronary_artery_disease_and_cardiovascular_outcome_in_women:_the_National_Heart_Lung_and_Blood_Institute_Sponsored_Women's_Ischemia_Syndrome_Evaluation__WISE__ L2 - http://www.ahajournals.org/doi/full/10.1161/01.CIR.0000115516.54550.B1?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -