Circulating Levels of Dephosphorylated-Uncarboxylated Matrix Gla Protein in Patients with Acute Coronary Syndrome |
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Authors: | Admira Bilalic Tina Ticinovic Kurir Marko Kumric Josip A. Borovac Andrija Matetic Daniela Supe-Domic Josko Bozic |
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Affiliation: | 1.Department of Cardiology, University Hospital of Split, Split 21000, Croatia; (A.B.); (A.M.);2.Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (T.T.K.); (M.K.); (J.A.B.);3.Endocrinology Clinic, University Hospital of Split, 21000 Split, Croatia;4.Institute of Emergency Medicine of Split-Dalmatia County (ZHM SDZ), 21000 Split, Croatia;5.Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia; |
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Abstract: | Vascular calcification contributes to the pathogenesis of coronary artery disease while matrix Gla protein (MGP) was recently identified as a potent inhibitor of vascular calcification. MGP fractions, such as dephosphorylated-uncarboxylated MGP (dp-ucMGP), lack post-translational modifications and are less efficient in vascular calcification inhibition. We sought to compare dp-ucMGP levels between patients with acute coronary syndrome (ACS), stratified by ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) status. Physical examination and clinical data, along with plasma dp-ucMGP levels, were obtained from 90 consecutive ACS patients. We observed that levels of dp-ucMGP were significantly higher in patients with NSTEMI compared to STEMI patients (1063.4 ± 518.6 vs. 742.7 ± 166.6 pmol/L, p < 0.001). NSTEMI status and positive family history of cardiovascular diseases were only independent predictors of the highest tertile of dp-ucMGP levels. Among those with NSTEMI, patients at a high risk of in-hospital mortality (adjudicated by GRACE score) had significantly higher levels of dp-ucMGP compared to non-high-risk patients (1417.8 ± 956.8 vs. 984.6 ± 335.0 pmol/L, p = 0.030). Altogether, our findings suggest that higher dp-ucMGP levels likely reflect higher calcification burden in ACS patients and might aid in the identification of NSTEMI patients at increased risk of in-hospital mortality. Furthermore, observed dp-ucMGP levels might reflect differences in atherosclerotic plaque pathobiology between patients with STEMI and NSTEMI. |
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Keywords: | matrix Gla protein acute coronary syndrome vascular calcification myocardial infarction STEMI NSTEMI |
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