Plasma angiogenin levels in acute coronary syndromes: implications for prognosis

Aims Angiogenin is a member of the ribonuclease superfamily, which has been implicated as a mitogen of endothelial cells and activator of matrix metalloproteinases and plasminogen-activated plasmin pathways. We hypothesized abnormalities of angiogenin levels in acute coronary syndrome (ACS), with prognostic implications for predicting adverse events. Methods and results We measured plasma angiogenin levels (ELISA) in 396 consecutive patients (63.4% males; mean age 67 years, SD 13) admitted with ACS, who were compared with 44 'disease controls' (patients with stable coronary artery disease) and 76 healthy controls. Clinical follow-up at 6 months was performed for adverse endpoints (cardiovascular death, recurrent ACS, revascularization and heart failure). ACS patients had significantly elevated plasma angiogenin levels compared with both disease controls and healthy controls (P < 0.001). After adjusting for baseline characteristics, raised troponin T levels and electrocardiographic changes, raised angiogenin levels were independently associated with more adverse events at 6 months' follow-up [HR 1.44 (95% CI: 1.10-1.89); P = 0.008]. Conclusion Plasma angiogenin levels are significantly increased in ACS, and may be involved in the pathogenesis of this condition. High angiogenin levels were predictive of adverse events during follow-up.