Clin Res Cardiol 98, Suppl 1, April 2009

V1617 - Phospholipid Transfer Protein Activity is a Risk Factor for subsequent Cardiovascular Events in Coronary Artery Disease Patients under Statin Therapy: the AtheroGene Study
A. Schlitt1, S. Blankenberg2, C. Bickel3, K. J. Lackner4, G. Heine5, M. Buerke1, K. Werdan1, L. Mägdefessel1, U. Raaz1, H.-J. Rupprecht6, T. Münzel2, X.-C. Jiang7
1Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle-Wittenberg, Halle/Saale; 2II. Medizinische Klinik und Poliklinik, Klinikum der Universität Mainz, Mainz; 3Abt. I - Innere Medizin, Kardiologie, Diabetologie, Bundeswehrzentralkrankenhaus Koblenz, Koblenz; 4Institute for Clinical Chemistry and Laboratory Medicine, Mainz; 5Klinik für Innere Medizin IV, Universitätsklinikum des Saarlandes, Homburg/Saar; 6II. Med. Klinik, GPR Klinikum Rüsselsheim, Rüsselsheim; 7SUNY Downstate Medical Center, Brooklyn, USA;
Background: Phospholipid transferprotein (PLTP) mediates both net transfer and exchange of phospholipids between different lipoproteins. Although many studies have investigated the role of PLTP in atherogenesis, the role of PLTP in atherosclerotic diseases is unclear.
Materials and Methods: We investigated the association of serum PLTP activity with the incidence of a combined endpoint (myocardial infarction and cardiovascular death) and its relation to other markers of atherosclerosis in 1,085 patients with angiographically documented CAD.
Results: In the median follow-up of 5.1 years, 156 patients had suffered from the combined endpoint of myocardial infarction or cardiovascular death. In Kaplan-Meyer analyses serum PLTP activity was not associated with the combined endpoint in all patients. However, in a subgroup of patients receiving statins at baseline (n=389), PLTP was shown to be a significant predictor of cardiovascular outcome (p=0.019), and this also remained stable in univariate (p=0.027) and multivariate cox regression analyses (p=0.041) including potential confounders (classical risk factors, HDL-C, and others).
Conclusion: This study indicates that elevated serum PLTP activity is a risk factor for CAD patients under statin therapy. We hypothesize that the efficacy of statin therapy in preventing further cardiovascular events in this patient group can be monitored by measuring PLTP activity.


Figure 1          
Kaplan-Meyer survival plots for combined endpoint (cardiovascular mortality and
myocardial infarction) after stratifying patients for PLTP levels (Figures 1a-c) and after stratifying for statin treatment (1d)                               
a) PLTP in quartiles, all subjects
b) PLTP in quartiles, patients not receiving statins at baseline
c) PLTP in quartiles, patients receiving statins at baseline
d) Statin treatment, all subjects