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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2007;27:929.)
© 2007 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Low Plasma RANTES Levels Are an Independent Predictor of Cardiac Mortality in Patients Referred for Coronary Angiography

Erdal Cavusoglu; Calvin Eng; Vineet Chopra; Luther T. Clark; David J. Pinsky; Jonathan D. Marmur

From the Division of Cardiology (E.C., L.T.C., J.D.M.), Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY; Division of Cardiology (E.C., C.E., V.C.), Department of Medicine, Bronx Veterans Affairs Medical Center, Bronx, NY; Division of Cardiovascular Medicine (D.J.P.), Department of Medicine, University of Michigan at Ann Arbor, Ann Arbor, Mich.

Correspondence to Erdal Cavusoglu, MD, SUNY Downstate Medical Center, 450 Clarkson Avenue, Box 1257, Brooklyn, NY 11203-2098. E-mail ECavusoglu{at}aol.com

Objective— Our objective was to evaluate the prognostic value of baseline plasma RANTES levels in patients with known or suspected coronary artery disease. RANTES is a chemokine produced by a variety of cell types including platelets that has been implicated in atherosclerosis.

Methods and Results— Baseline plasma RANTES levels were measured in 389 male patients undergoing coronary angiography at a Veterans Affairs Medical Center. The patients were followed-up prospectively for the occurrence of cardiac mortality and myocardial infarction. Follow-up data at 24 months were available for 97% of patients. In the entire cohort of patients, low baseline RANTES levels were an independent predictor of cardiac mortality. For cardiac death at 24 months, the survival rate was 87.3% in the lowest tertile of RANTES values, compared with 94% in the upper 2 tertiles combined (P=0.0298 by log rank test). Furthermore, when patients were risk-stratified into those with and without an acute coronary syndrome, RANTES was an independent predictor of both cardiac mortality and myocardial infarction in those without an acute coronary syndrome. Finally, RANTES was also an independent predictor of cardiac mortality in the diabetic subset.

Conclusions— In a cohort of male patients undergoing coronary angiography, low baseline plasma RANTES levels are an independent predictor of cardiac mortality.

RANTES is a chemokine implicated in atherosclerosis. In 389 male patients undergoing coronary angiography, low baseline plasma RANTES levels were independently predictive of cardiac death. Furthermore, RANTES levels were independent predictors of cardiac mortality and MI in the non-ACS subgroup, and of cardiac mortality in the diabetic subset.

Key Words: atherosclerosis • chemokine • inflammation • prognosis • RANTES

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