Tohoku J. Exp. Med., 2011, 223(4)

CXC Chemokine Ligand 16 as a Prognostic Marker in Patients with Intermediate Coronary Artery Lesions: A 2-Year Follow-Up Study

KAI TAN,¹ SHUZHENG LU,^1,2 YUNDAI CHEN,³ XIANTAO SONG,¹ XIAOFAN WU,¹ ZENING JIN,¹ FEI YUAN,¹ YUAN ZHOU,¹ HONG LI,¹ TINGSHU YANG,² YUJIE ZHOU,¹ ZHIZHONG LI,¹ FANG CHEN,¹ SHUYANG ZHANG,⁴ LIJUN GUO,⁵ WEIMIN WANG,⁶ QUANMING ZHAO,¹ YONG HUO,⁷ XINCHUN YANG,⁸ JINGHUA LIU,¹ BUXING CHEN,⁹ HONGBING YAN,¹ HONGWEI LI,¹⁰ YUANNAN KE,¹¹ KEJI CHEN1² and DAZHUO SHI¹²

¹Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China
²Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, P.R. China
³Chinese PLA General Hospital, Beijing, P.R. China
⁴Peking Union Medical College Hospital, Beijing, P.R. China
⁵Peking University Third Hospital, Beijing, P.R. China
⁶Peking University People's Hospital, Beijing, P.R. China
⁷Peking University First Hospital, Beijing, P.R. China
⁸Beijing Chao-Yang Hospital, Capital medical University, Beijing, P.R. China
⁹Beijing Electric Power Hospital, Beijing, P.R. China
¹⁰Beijing Friendship Hospital, Capital medical University, Beijing, P.R. China
¹¹China-Japan Friendship Hospital, Beijing, P.R. China
¹²Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, P.R. China

There is no reliable way to identify the high-risk patients with intermediate coronary artery lesions (diameter stenosis 20%-70%) in early stage. Soluble CXC chemokine ligand 16 (CXCL16) is a newly discovered chemokine that can mediate inflammatory responses. It is released by proteolytic cleavage of its membrane-bound form, named scavenger receptor for phosphatidylserine and oxidized lipoprotein (SR-PSOX) that can promote the uptake of oxidized low-density lipoprotein cholesterol by macrophages. We have hypothesized that CXCL16 is an indicator of the prognosis of intermediate coronary artery lesions, and thus assessed the association between plasma CXCL16 concentrations and the 2-year prognosis in 616 patients with intermediate coronary artery lesions. The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, revascularization and angina pectoris requiring re-hospitalization. During the median follow-up time of 24 months, 69 events occurred. The plasma concentrations of CXCL16 (median 7712.88 pg/ml vs. 6792.43 pg/ml, P = 0.014) and high-sensitivity C-reactive protein (hs-CRP) (median 2.82 mg/L vs. 1.68 mg/L, P < 0.001) were higher in patients with events than patients without events. Cox hazard proportion analysis showed patients in upper CXCL16 quartile were more likely to suffer from adverse outcome than patients in lower quartile (RR = 1.271, P = 0.029, 95% CI: 1.025-1.577) after adjusting for sex, age, smoking, hypertension, diabetes, fat, dyslipidemia, hs-CRP, and medication use. In conclusion, plasma level of CXCL16 is an independent predictor of the prognosis of the patients with intermediate coronary lesions. Elevated plasma CXCL16 is associated with higher risk for these patients.

keywords —— coronary artery disease; intermediate lesion; CXCL16; atherosclerosis; prognosis

© 2011 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2011, 223, 277-283

Correspondence: Shuzheng Lu, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China.

e-mail: shuzheng@medmail.com.cn