Journal
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY
Volume 31, Issue 3, Pages 698-704Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/ATVBAHA.110.219329
Keywords
angina pectoris; epidemiology; immune system; risk factors
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Funding
- Norwegian Foundation for Health and Rehabilitation
- Norwegian Heart and Lung Patient Organization
- Norwegian Ministry of Health and Care Services
- Western Norway Regional Health Authority
- Foundation to Promote Research into Functional Vitamin B12-Deficiency
- Department of Heart Disease, Haukeland University Hospital, Norway
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Objective-Interferon gamma (IFN-gamma) is centrally involved in atherosclerosis-related inflammation, but its activity cannot be reliably assessed by systemic measurements. In activated macrophages, IFN-gamma stimulates production of neopterin and conversion of tryptophan to kynurenine. We evaluated the relationships of plasma neopterin and plasma kyunernine: tryptophan ratio (KTR) to long-term prognosis in patients with stable angina pectoris and angiographically verified significant coronary artery disease. Methods and Results-Samples were obtained from 2380 patients with a mean age of 63.7 years; 77.3% were men. During a median follow-up of 56 months, 10.8% of patients experienced a major coronary event (MCE), and 9.5% died. For MCE, each SD increment of neopterin and KTR (logarithmically transformed) was associated with multivariable adjusted hazard ratios and 95% CIs of 1.28 (1.10 to 1.48) and 1.28 (1.12 to 1.48), respectively. The corresponding hazard ratios (95% CIs) for all-cause mortality were 1.40 (1.21 to 1.62) (neopterin) and 1.23 (1.06 to 1.43) (KTR). Conclusion-In patients with stable angina pectoris, systemic markers of IFN-gamma activity, plasma neopterin, and plasma KTR provide similar risk estimates for MCE and mortality. Our results support experimental data linking IFN-gamma to acute atherosclerotic complications. (Arterioscler Thromb Vasc Biol. 2011;31:698-704.)
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