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Serum complement C3/C4 ratio, a novel marker for recurrent cardiovascular events.
Am J Cardiol. 2007 Apr 1;99(7):890-5
Publication Type
Anil Palikhe
Juha Sinisalo
Mikko Seppänen
Heikki Haario
Seppo Meri
Ville Valtonen
Markku S Nieminen
Marja-Liisa Lokki
Author Affiliation
Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
Am J Cardiol. 2007 Apr 1;99(7):890-5
Publication Type
Analysis of Variance
Angina, Unstable - blood - mortality
Biological Markers - blood
Cerebral Infarction - blood - mortality
Complement C3 - genetics - metabolism
Complement C4 - genetics - metabolism
Coronary Disease - blood - epidemiology
Finland - epidemiology
Follow-Up Studies
Inflammation Mediators - blood
Kaplan-Meier Estimate
Logistic Models
Middle Aged
Myocardial Infarction - blood - mortality
Natriuretic Peptide, Brain - blood
Proportional Hazards Models
Randomized Controlled Trials as Topic
Risk factors
Sensitivity and specificity
Survival Analysis
Acute coronary syndrome is an inflammatory disease, during which the complement cascade is activated. We assessed the complement C3 and C4 concentration ratio (C3/C4 ratio) in serum as a potential measurement to predict cardiovascular attacks. Patients with acute coronary syndrome (n=148) were followed after an initial attack for subsequent ischemic cardiovascular events (composite end point of death, myocardial infarction, recurrent unstable angina, or stroke). During the follow-up period (average 555 days), 44 patients met an end point. Blood samples were taken at hospitalization, 1 week, 3 months, and 1 year after hospital admission. Serum complement C3 and C4 concentrations and the C3/C4 ratio were analyzed. Patients with an end point had, throughout the follow-up period, a higher C3/C4 ratio than patients without these end points (repeated measures analysis of variance, p=0.007). When all traditional cardiovascular risk factors and other potential confounding factors were included in a Cox multivariate logistic regression survival analysis, the C3/C4 ratio emerged as the novel risk factor for any new cardiovascular event (odds ratio 1.33, 95% confidence interval 1.08 to 1.63, p=0.007). When the C3/C4 ratio was divided into 4 quartiles, 24% in quartiles 1 and 2 (lowest) and 48% in quartile 4 (highest) had end points during follow-up (odds ratio 3.04, 95% confidence interval 1.27 to 7.29, p=0.01). In conclusion, increased serum C3/C4 ratio is a readily available and novel marker for recurrent cardiovascular events in acute coronary syndrome. The relative increase in serum C3 protein and decrease in C4 protein could explain changes in the C3/C4 ratio.
PubMed ID
17398178 View in PubMed
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