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Association between high plasma levels of legumain and cardiovascular events in patients undergoing coronary angiography

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Abstract

Degradation of vascular extracellular matrix is important in atherosclerosis. Cysteine protease legumain is upregulated in atherosclerotic plaques. We recently reported that plasma legumain levels are high in patients with complex coronary lesions. This study investigated the association between legumain levels and cardiovascular events in 372 patients undergoing coronary angiography. Patients with acute coronary syndrome were excluded. Of the 372 patients, 225 had coronary artery disease (CAD). During a mean follow-up of 7.0 ± 4.3 years, cardiovascular events occured in 62 patients. Compared with 310 patients without events, 62 with events tended to have higher prevalence of complex lesions (15% vs. 10%). Notably, patients with events had higher legumain levels (median 5.51 vs. 4.90 ng/mL, P < 0.01) than those without events. A Kaplan-Meier analysis showed lower event-free survival in patients with legumain > 5.0 ng/mL than in those with ≤ 5.0 ng/mL (P < 0.01). In multivariate Cox regression analysis, legumain level was an independent predictor of cardiovascular events. The hazard ratio for legumain > 5.0 ng/mL for cardiovascular events was 2.18 (95%CI = 1.27–3.77, P < 0.01). Only among 225 patients with CAD, patients with events had higher legumain levels (5.49 vs. 4.73 ng/mL) than without events (P < 0.02). Legumain level was also a predictor of cardiovascular events in patients with CAD. Thus, high plasma legumain levels were associated with an increased risk of cardiovascular events in patients undergoing coronary angiography and those with stable CAD.

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Funding

This study was supported by a grant from the Honjo International Scholarship Foundation. Financial funding was also provided by Pfizer Japan Inc. However, these sponsors had no role in the design, analysis, or interpretation of our study.

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Authors and Affiliations

  1. Department of Cardiology, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan

    Yukihiko Momiyama

  2. Department of Food Science and Human Nutrition, Setsunan University, Osaka, Japan

    Yoshimi Kishimoto

  3. Research Institute of Environmental Medicine, Nagoya University, Aichi, Japan

    Emi Saita

  4. Faculty of Regional Design, Utsunomiya University, Tochigi, Japan

    Reiko Ohmori

  5. Ochanomizu University, Tokyo, Japan

    Kazuo Kondo

Authors
  1. Yukihiko Momiyama
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  2. Yoshimi Kishimoto
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  3. Emi Saita
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  4. Reiko Ohmori
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  5. Kazuo Kondo
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Correspondence to Yukihiko Momiyama.

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Momiyama, Y., Kishimoto, Y., Saita, E. et al. Association between high plasma levels of legumain and cardiovascular events in patients undergoing coronary angiography. Heart Vessels (2024). https://doi.org/10.1007/s00380-024-02373-x

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