There is considerable interest in identifying biomarkers indicative of plaque instability and acute events. Previously we reported that MDA-LDL in circulating immune complex predicted acute myocardial infarction (MI) in the VADT study. Interleukin (IL)-6, Fas Ligand, tissue inhibitor of MMP (TIMP)-1 and monocyte chemotactic protein (MCP)-1 have been identified as potentially clinically relevant biomarkers related to plaque instability. Therefore, our objective was to examine the role of these biomarkers in conjunction with MDA-LDL in circulating immune complex as predictors of acute MI in type 2 diabetes. Biomarker levels were measured in 833 VADT patients, a median of 2.0 years after study entry and participants were subsequently followed a median of 3.7 years. Biomarkers were examined individually and as composite scores created by summing z scores across biomarkers. Hazard ratios (HRs) for acute MI were calculated by Cox proportional hazard models. During follow-up, 5.2% had an MI. After adjustment for conventional risk factors, results of composite biomarkers scores were promising with a hazard ratio for acute MI of 4.65 (95% CI: 1.56, 13.9) comparing the fourth to first quartile of our summary composite score which included MDA-LDL-IC, IL-6, Fas Ligand,TIMP-1 and MCP-1 (Table).


M.F.L. Lopes-Virella: None. K.J. Hunt: None. R. Agarwal: None. N.L. Baker: Research Support; Self; Bristol-Myers Squibb Company. G. Virella: None.

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