Elevated levels of circulating DNA and chromatin are independently associated with severe coronary atherosclerosis and a prothrombotic state
Standard
Elevated levels of circulating DNA and chromatin are independently associated with severe coronary atherosclerosis and a prothrombotic state. / Borissoff, Julian I; Joosen, Ivo A; Versteylen, Mathijs O; Brill, Alexander; Fuchs, Tobias A; Savchenko, Alexander S; Gallant, Maureen; Martinod, Kimberly; Ten Cate, Hugo; Hofstra, Leonard; Crijns, Harry J; Wagner, Denisa D; Kietselaer, Bas L J H.
In: ARTERIOSCL THROM VAS, Vol. 33, No. 8, 01.08.2013, p. 2032-40.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Elevated levels of circulating DNA and chromatin are independently associated with severe coronary atherosclerosis and a prothrombotic state
AU - Borissoff, Julian I
AU - Joosen, Ivo A
AU - Versteylen, Mathijs O
AU - Brill, Alexander
AU - Fuchs, Tobias A
AU - Savchenko, Alexander S
AU - Gallant, Maureen
AU - Martinod, Kimberly
AU - Ten Cate, Hugo
AU - Hofstra, Leonard
AU - Crijns, Harry J
AU - Wagner, Denisa D
AU - Kietselaer, Bas L J H
N1 - Fuchs für Boston Childrens Hosp, Program Cellular & Mol Med, Boston, MA USA
PY - 2013/8/1
Y1 - 2013/8/1
N2 - OBJECTIVE: Aberrant neutrophil activation occurs during the advanced stages of atherosclerosis. Once primed, neutrophils can undergo apoptosis or release neutrophil extracellular traps. This extracellular DNA exerts potent proinflammatory, prothrombotic, and cytotoxic properties. The goal of this study was to examine the relationships among extracellular DNA formation, coronary atherosclerosis, and the presence of a prothrombotic state.APPROACH AND RESULTS: In a prospective, observational, cross-sectional cohort of 282 individuals with suspected coronary artery disease, we examined the severity, extent, and phenotype of coronary atherosclerosis using coronary computed tomographic angiography. Double-stranded DNA, nucleosomes, citrullinated histone H4, and myeloperoxidase-DNA complexes, considered in vivo markers of cell death and NETosis, respectively, were established. We further measured various plasma markers of coagulation activation and inflammation. Plasma double-stranded DNA, nucleosomes, and myeloperoxidase-DNA complexes were positively associated with thrombin generation and significantly elevated in patients with severe coronary atherosclerosis or extremely calcified coronary arteries. Multinomial regression analysis, adjusted for confounding factors, identified high plasma nucleosome levels as an independent risk factor of severe coronary stenosis (odds ratio, 2.14; 95% confidence interval, 1.26-3.63; P=0.005). Markers of neutrophil extracellular traps, such as myeloperoxidase-DNA complexes, predicted the number of atherosclerotic coronary vessels and the occurrence of major adverse cardiac events.CONCLUSIONS: Our report provides evidence demonstrating that markers of cell death and neutrophil extracellular trap formation are independently associated with coronary artery disease, prothrombotic state, and occurrence of adverse cardiac events. These biomarkers could potentially aid in the prediction of cardiovascular risk in patients with chest discomfort.
AB - OBJECTIVE: Aberrant neutrophil activation occurs during the advanced stages of atherosclerosis. Once primed, neutrophils can undergo apoptosis or release neutrophil extracellular traps. This extracellular DNA exerts potent proinflammatory, prothrombotic, and cytotoxic properties. The goal of this study was to examine the relationships among extracellular DNA formation, coronary atherosclerosis, and the presence of a prothrombotic state.APPROACH AND RESULTS: In a prospective, observational, cross-sectional cohort of 282 individuals with suspected coronary artery disease, we examined the severity, extent, and phenotype of coronary atherosclerosis using coronary computed tomographic angiography. Double-stranded DNA, nucleosomes, citrullinated histone H4, and myeloperoxidase-DNA complexes, considered in vivo markers of cell death and NETosis, respectively, were established. We further measured various plasma markers of coagulation activation and inflammation. Plasma double-stranded DNA, nucleosomes, and myeloperoxidase-DNA complexes were positively associated with thrombin generation and significantly elevated in patients with severe coronary atherosclerosis or extremely calcified coronary arteries. Multinomial regression analysis, adjusted for confounding factors, identified high plasma nucleosome levels as an independent risk factor of severe coronary stenosis (odds ratio, 2.14; 95% confidence interval, 1.26-3.63; P=0.005). Markers of neutrophil extracellular traps, such as myeloperoxidase-DNA complexes, predicted the number of atherosclerotic coronary vessels and the occurrence of major adverse cardiac events.CONCLUSIONS: Our report provides evidence demonstrating that markers of cell death and neutrophil extracellular trap formation are independently associated with coronary artery disease, prothrombotic state, and occurrence of adverse cardiac events. These biomarkers could potentially aid in the prediction of cardiovascular risk in patients with chest discomfort.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Biological Markers
KW - Chromatin
KW - Coronary Artery Disease
KW - Cross-Sectional Studies
KW - DNA
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Neutrophils
KW - Nucleosomes
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Risk Factors
KW - Severity of Illness Index
KW - Thrombosis
KW - Tomography, X-Ray Computed
KW - von Willebrand Factor
U2 - 10.1161/ATVBAHA.113.301627
DO - 10.1161/ATVBAHA.113.301627
M3 - SCORING: Journal article
C2 - 23818485
VL - 33
SP - 2032
EP - 2040
JO - ARTERIOSCL THROM VAS
JF - ARTERIOSCL THROM VAS
SN - 1079-5642
IS - 8
ER -
