High-Serum Angiopoietin-Like Protein 3 Levels Associated with Cardiovascular Outcome in Patients with Coronary Artery Disease

Abstract

Background. Angiopoietin-like protein 3 (ANGPTL3) plays a pivotal role in lipid metabolism and angiogenesis, and there is growing interest regarding the association between ANGPTL3 and coronary artery disease (CAD). This study aims to investigate whether ANGPTL3 levels can be used to predict the future occurrence of major adverse cardiovascular events (MACEs) in patients with CAD. Methods. Overall, 90 patients with CAD were enrolled between January and December 2012. The study’s primary endpoint was incidence of MACEs. Patient follow-up was completed on June 30, 2017. Results. Following a median follow-up period of 54 months, 33 MACEs had occurred. Patients reporting MACEs had lower statin use (P=0.022) and higher serum C-reactive protein (P<0.001) and serum ANGPTL3 (P<0.001) levels than those without MACEs. Kaplan–Meier analysis revealed higher cumulative incidence of CV events in the high ANGPTL3 group (median ANGPTL3 level ≥ 222.37 ng/mL) than in the low ANGPTL3 group (log-rank P=0.046). Multivariable Cox regression analysis demonstrated that ANGPTL3 levels were independently associated with MACEs in patients with CAD (hazard ratio: 1.003; 95% confidence interval: 1.000–1.005; P=0.026) after adjusted for age, gender, and body mass index, classical risk factors, and potential confounders. Conclusions. Serum ANGPTL3 levels could serve as a biomarker for future occurrence of MACEs in patients with CAD.

Targeting angiopoietin‐like 3 in atherosclerosis: From bench to bedside

“…66 Also, in a prospective cohort study in which 90 patients with ASCVD were enrolled, the relationship between baseline serum ANGPTL3 levels and the risk of major adverse cardiovascular events (MACEs) was explored: not only did patients with ASCVD have higher plasma levels of ANGPTL3, but circulating ANGPTL3 proteins were independently related to the higher risk of MACEs among subjects with ASCVD. 84 Similarly, Li et al 87 showed that in patients with obstructive sleep apnoea syndrome, elevated levels of ANGPTL3 predicted a higher risk of ASCVD. The intima-media thickness (IMT) of carotid arteries (CA) and IMT-femoral arteries (FA) are two metrics for estimating the extent of atherosclerosis.…”

“…Evolving evidence supports the contention that ANGPTL3 plays an important role in lipid metabolism. Several studies revealed that plasma ANGPTL3 levels were positively associated with circulating LDL‐C and HDL‐C, indicating that circulating ANGPTL3 proteins could be a potential ASCVD biomarker 41,84‐86 . In a population‐based study, patients in the lowest tertile of plasma ANGPTL3 levels showed a reduced ASCVD risk by 29% compared with those in the highest tertile 66 .…”

“…In a population‐based study, patients in the lowest tertile of plasma ANGPTL3 levels showed a reduced ASCVD risk by 29% compared with those in the highest tertile 66 . Also, in a prospective cohort study in which 90 patients with ASCVD were enrolled, the relationship between baseline serum ANGPTL3 levels and the risk of major adverse cardiovascular events (MACEs) was explored: not only did patients with ASCVD have higher plasma levels of ANGPTL3, but circulating ANGPTL3 proteins were independently related to the higher risk of MACEs among subjects with ASCVD 84 . Similarly, Li et al 87 showed that in patients with obstructive sleep apnoea syndrome, elevated levels of ANGPTL3 predicted a higher risk of ASCVD.…”

“…Several studies revealed that plasma ANGPTL3 levels were positively associated with circulating LDL-C and HDL-C, indicating that circulating ANGPTL3 proteins could be a potential ASCVD biomarker. 41,[84][85][86] In a population-based study, patients in the lowest tertile of plasma ANGPTL3 levels showed a reduced ASCVD risk by 29% compared with those in the highest tertile. 66 Also, in a prospective cohort study in which 90 patients with ASCVD were enrolled, the relationship between baseline serum ANGPTL3 levels and the risk of major adverse cardiovascular events (MACEs) was explored: not only did patients with ASCVD have higher plasma levels of ANGPTL3, but circulating ANGPTL3 proteins were independently related to the higher risk of MACEs among subjects with ASCVD.…”

Serum Angiopoietin-like Protein 3 Level Is Associated with Peripheral Arterial Stiffness in Patients with Coronary Artery Disease

“…Body weight and height (Tanita WB-380, Tanita Corporation, Tokyo, Japan) were recorded to the nearest 0.5 kg and 0.5 cm, respectively. Body mass index was calculated as the weight in kilograms divided by the height in meters squared [17,18].…”