Emerging Cardiovascular Disease Biomarkers and Incident Diabetes Mellitus Risk in Statin-Treated Patients with Coronary Artery Disease (From the Treating to New Targets [TNT] Study)

• Published in: The American journal of cardiology Vol. 118; no. 4; pp. 494 - 498
• Main Authors: Arsenault, Benoit J., PhD, Kohli, Payal, MD, Lambert, Gilles, PhD, DeMicco, David A., PharmD, Laskey, Rachel, PhD, Messig, Michael M., PhD, Kastelein, John J.P., MD, PhD, Waters, David D., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.08.2016; Elsevier Limited
• Subjects: 1-Alkyl-2-acetylglycerophosphocholine Esterase - blood; Adiponectin - blood; Aged; Atorvastatin Calcium - therapeutic use; Biomarkers - blood; C-Reactive Protein - metabolism; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases - blood; CD40 Ligand - blood; Cell adhesion & migration; Chemokine CCL2 - blood; Coronary Artery Disease - blood; Coronary Artery Disease - drug therapy; Cystatin C - blood; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - epidemiology; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Incidence; Insulin - blood; Intercellular Adhesion Molecule-1 - blood; Lipids; Lipoprotein(a) - blood; Low density lipoprotein; Male; Matrix Metalloproteinase 9 - blood; Middle Aged; Multivariate Analysis; Natriuretic Peptide, Brain - blood; Neopterin - blood; Osteopontin - blood; Peptide Fragments - blood; Peroxidase - blood; Plasma; Randomized Controlled Trials as Topic; Receptor for Advanced Glycation End Products - blood; Risk Factors; Secondary Prevention; Vascular Cell Adhesion Molecule-1 - blood; Vitamin D - blood; diabetes mellitus; cardiovascular risk factors; biomarkers; statins
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2016.05.044

Abstract Whether biomarkers associated with cardiovascular disease (CVD) risk also predict incident diabetes mellitus (DM) is unknown. Our objective is to determine if a panel of 18 biomarkers previously associated with risk of CVD also predicts incident DM in statin-treated patients with coronary artery disease (CAD). The Treating to New Targets (TNT) study population, a randomized trial that compared the efficacy of high (80mg) vs. low (10mg) dose atorvastatin for the secondary prevention of coronary heart disease events. Fasting plasma levels of standard lipids and of 18 emerging CAD risk biomarkers were obtained after an 8-week run-in period on atorvastatin 10mg in a random sample of 1424 TNT patients. After exclusion of patients with DM at baseline (n=253), 101 patients developed DM during the median follow-up of 4.9 years. Patients with incident DM had lower levels of total and high-molecular weight (HMW) adiponectin, Lp-PLA2, sRAGE and vitamin D compared to patients without incident DM. In contrast, insulin, sCD40L and sICAM-1 levels were higher in patients with incident DM compared with those without. Plasma levels of C-reactive protein, cystatin C, Lipoprotein(a), MCP-1, MMP-9, myeloperoxidase, neopterin, Nt-pro BNP, osteopontin, and sVCAM-1 were comparable in patients with and without incident DM. After multivariate adjustment, total and HMW adiponectin as well as Lp-PLA2 were negatively associated with incident DM. Results of this study suggest that plasma lipids and some emerging CAD risk biomarkers, such as adiponectin and Lp-PLA2, may be useful for predicting incident DM in statin-treated patients with stable CAD.