Document Detail

Neopterin as a predictor of total and cardiovascular mortality in individuals undergoing angiography in the Ludwigshafen Risk and Cardiovascular Health study.
MedLine Citation:
PMID:  19395439     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Neopterin is produced upon activation of the cell-mediated immune response, and may be a novel risk marker for adverse outcomes resulting from coronary artery disease. METHODS: We measured neopterin in 1801 study participants with and 511 without angiographic coronary artery disease. Rates of death were determined after a median follow-up of 8.0 years. RESULTS: Estimated glomerular filtration rate and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were the strongest predictors of neopterin. Neopterin was positively related to age and inversely related to LDL cholesterol, HDL cholesterol, and triglycerides. Use of lipid-lowering drugs lowered neopterin. Sex, body mass index, diabetes mellitus, hypertension, smoking status, Friesinger coronary score, and clinical instability at presentation were not associated with neopterin. Unlike C-reactive protein, neopterin was not increased in unstable angina pectoris, non-ST-elevation myocardial infarction, or ST-elevation myocardial infarction. In the third and fourth quartiles of neopterin, unadjusted hazard ratios for death from any cause were 1.94 (95% CI 1.44-2.61) and 3.32 (95% CI 2.53-4.30) compared to individuals in the first quartile, whereas hazard ratios for death from cardiovascular causes were 2.14 (95% CI 1.44-3.18) and 3.84 (95% CI 2.67-5.52), respectively. Neopterin remained predictive of total and cardiovascular mortality after adjusting for sex, age, body mass index, type 2 diabetes, hypertension, smoking status, LDL cholesterol, HDL cholesterol, triglycerides, estimated glomerular filtration rate, NT-proBNP, and clinical status at presentation, but NT-proBNP substantially weakened this association. CONCLUSIONS: Neopterin is an independent predictor of all-cause and cardiovascular mortality in individuals with or without stable coronary artery disease.
Tanja B Grammer; Dietmar Fuchs; Bernhard O Boehm; Bernhard R Winkelmann; Winfried Maerz
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Publication Detail:
Type:  Journal Article     Date:  2009-04-24
Journal Detail:
Title:  Clinical chemistry     Volume:  55     ISSN:  1530-8561     ISO Abbreviation:  Clin. Chem.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-29     Completed Date:  2009-06-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421549     Medline TA:  Clin Chem     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1135-46     Citation Subset:  IM    
Synlab Centre of Laboratory Diagnostics Heidelberg, Heidelberg, Germany. tanja.grammer@
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MeSH Terms
Biological Markers / blood
Cardiovascular Diseases / blood,  mortality*
Coronary Angiography*
Glomerular Filtration Rate
Middle Aged
Neopterin / blood*
Reg. No./Substance:
0/Biological Markers; 670-65-5/Neopterin
Comment In:
Clin Chem. 2009 Jun;55(6):1056-7   [PMID:  19395434 ]

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