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

• Published in: Heart and vessels Vol. 39; no. 10; pp. 909 - 915
• Main Authors: Momiyama, Yukihiko, Kishimoto, Yoshimi, Saita, Emi, Ohmori, Reiko, Kondo, Kazuo
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.10.2024; Springer Nature B.V
• Subjects: Aged; Angiography; Arteriosclerosis; Atherosclerosis; Biomarkers - blood; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Cardiovascular disease; Cardiovascular diseases; Coronary Angiography; Coronary artery disease; Coronary Artery Disease - blood; Coronary Artery Disease - diagnosis; Coronary Artery Disease - diagnostic imaging; Cysteine Endopeptidases - blood; Cysteine proteinase; Extracellular matrix; Female; Follow-Up Studies; Health risks; Heart diseases; Humans; Japan - epidemiology; Legumain; Lesions; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Plasma levels; Prognosis; Regression analysis; Retrospective Studies; Risk Assessment - methods; Risk Factors; Short Communication; Time Factors; Vascular Surgery; Japan; Cardiovascular events; Biomarker; Legumain; Coronary artery disease
• ISSN: 0910-8327; 1615-2573; 1615-2573
• DOI: 10.1007/s00380-024-02373-x

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.