Subgroups of monocytes predict cardiovascular events in patients with coronary heart disease. The PHAMOS trial (Prospective Halle Monocytes Study).


Journal

Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese
ISSN: 2241-5955
Titre abrégé: Hellenic J Cardiol
Pays: Netherlands
ID NLM: 101257381

Informations de publication

Date de publication:
Historique:
received: 16 09 2018
revised: 19 04 2019
accepted: 22 04 2019
pubmed: 6 5 2019
medline: 2 6 2020
entrez: 6 5 2019
Statut: ppublish

Résumé

Monocytes can be differentiated by the presence of CD14 and CD16 (CD14++CD16-, classical; CD14++CD16+, intermediate and CD14 + CD16++, non-classical monocytes). Recent studies have reported conflicting results regarding an association between subtypes of monocytes as defined by the expression of these two surface markers in atherosclerosis. We investigated subtypes of monocytes in n = 994 patients with angiographically documented coronary artery disease (CAD). We compared total numbers of monocyte subgroups stratified by tertiles with the occurrence of the pre-defined combined endpoint (non-fatal myocardial infarction, cardiovascular death and non-haemorrhagic cerebral insult). Patients were followed up for a minimum of 52 weeks. Classical risk factors of coronary heart disease were included in multivariate analysis. The primary endpoint occurred 134 times at a median time of 34.5 weeks (IR 10.6/59.6). Intermediate (p = 0.813), non-classical (p = 0.725) and the number of total monocytes (p = 0.626) stratified by tertiles showed no significant association with the combined endpoint. However, a higher absolute number of classical monocytes divided in tertiles was associated with incidence of the combined endpoint {T1 = 8.9% vs T2 = 14.2% vs T3 = 16.0% (p = 0.021)}. When comparing the third with the first tertile of Mo1 population, multivariate analysis showed a hazard ratio of 1.646 (CI: 1.005-2.699, p = 0.048). The absolute counts of classical monocytes divided in tertiles are predictive of major adverse cardiac events in patients with CAD. A tremendous shift from classical to intermediate monocytes was also confirmed in patients with CAD. These data highlight the importance of CD14++ monocytes in cardiovascular diseases.

Sections du résumé

BACKGROUND BACKGROUND
Monocytes can be differentiated by the presence of CD14 and CD16 (CD14++CD16-, classical; CD14++CD16+, intermediate and CD14 + CD16++, non-classical monocytes). Recent studies have reported conflicting results regarding an association between subtypes of monocytes as defined by the expression of these two surface markers in atherosclerosis.
METHODS METHODS
We investigated subtypes of monocytes in n = 994 patients with angiographically documented coronary artery disease (CAD). We compared total numbers of monocyte subgroups stratified by tertiles with the occurrence of the pre-defined combined endpoint (non-fatal myocardial infarction, cardiovascular death and non-haemorrhagic cerebral insult). Patients were followed up for a minimum of 52 weeks. Classical risk factors of coronary heart disease were included in multivariate analysis.
RESULTS RESULTS
The primary endpoint occurred 134 times at a median time of 34.5 weeks (IR 10.6/59.6). Intermediate (p = 0.813), non-classical (p = 0.725) and the number of total monocytes (p = 0.626) stratified by tertiles showed no significant association with the combined endpoint. However, a higher absolute number of classical monocytes divided in tertiles was associated with incidence of the combined endpoint {T1 = 8.9% vs T2 = 14.2% vs T3 = 16.0% (p = 0.021)}. When comparing the third with the first tertile of Mo1 population, multivariate analysis showed a hazard ratio of 1.646 (CI: 1.005-2.699, p = 0.048).
CONCLUSIONS CONCLUSIONS
The absolute counts of classical monocytes divided in tertiles are predictive of major adverse cardiac events in patients with CAD. A tremendous shift from classical to intermediate monocytes was also confirmed in patients with CAD. These data highlight the importance of CD14++ monocytes in cardiovascular diseases.

Identifiants

pubmed: 31055050
pii: S1109-9666(18)30426-3
doi: 10.1016/j.hjc.2019.04.012
pii:
doi:

Substances chimiques

Biomarkers 0
FCGR3B protein, human 0
GPI-Linked Proteins 0
Lipopolysaccharide Receptors 0
Receptors, IgG 0

Types de publication

Clinical Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

311-321

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.

Auteurs

Florian Höpfner (F)

University Hospital Halle of the Martin-Luther-University Halle-Wittenberg, Mid-German Heart Center, Department of Medicine III, Germany. Electronic address: Florian.Hoepfner@uk-halle.de.

Marrit Jacob (M)

University Hospital Halle of the Martin-Luther-University Halle-Wittenberg, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.

Christof Ulrich (C)

University Hospital Halle of the Martin-Luther-University Halle-Wittenberg, Department of Medicine II, Germany.

Martin Russ (M)

University Hospital Halle of the Martin-Luther-University Halle-Wittenberg, Mid-German Heart Center, Department of Medicine III, Germany.

Andreas Simm (A)

University Hospital Halle of the Martin-Luther-University Halle-Wittenberg, Department of Cardiothoracic Surgery, Germany.

Rolf E Silber (RE)

University Hospital Halle of the Martin-Luther-University Halle-Wittenberg, Department of Cardiothoracic Surgery, Germany.

Matthias Girndt (M)

University Hospital Halle of the Martin-Luther-University Halle-Wittenberg, Department of Medicine II, Germany.

Michel Noutsias (M)

University Hospital Halle of the Martin-Luther-University Halle-Wittenberg, Mid-German Heart Center, Department of Medicine III, Germany.

Karl Werdan (K)

University Hospital Halle of the Martin-Luther-University Halle-Wittenberg, Mid-German Heart Center, Department of Medicine III, Germany.

Axel Schlitt (A)

University Hospital Halle of the Martin-Luther-University Halle-Wittenberg, Mid-German Heart Center, Department of Medicine III, Germany; Paracelsus Harz-Clinic Bad Suderode, Germany.

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Classifications MeSH