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High betatrophin in coronary patients protects from cardiovascular events

  • Andreas Leiherer
    Correspondence
    Corresponding author. Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Academic Teaching Hospital Feldkirch, Carinagasse 47, A-6800, Feldkirch, Austria.
    Affiliations
    Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria

    Private University of the Principality of Liechtenstein, Triesen, Liechtenstein

    Medical Central Laboratories, Feldkirch, Austria
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  • Janine Ebner
    Affiliations
    Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria

    Medical Central Laboratories, Feldkirch, Austria
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  • Axel Muendlein
    Affiliations
    Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria

    Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
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  • Eva M. Brandtner
    Affiliations
    Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
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  • Christina Zach
    Affiliations
    Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria

    Medical Central Laboratories, Feldkirch, Austria
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  • Kathrin Geiger
    Affiliations
    Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
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  • Peter Fraunberger
    Affiliations
    Private University of the Principality of Liechtenstein, Triesen, Liechtenstein

    Medical Central Laboratories, Feldkirch, Austria
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  • Heinz Drexel
    Affiliations
    Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria

    Private University of the Principality of Liechtenstein, Triesen, Liechtenstein

    Drexel University College of Medicine, Philadelphia, PA, USA

    Division of Angiology, Swiss Cardiovascular Center, University Hospital of Bern, Switzerland
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      Highlights

      • Betatrophin was measured in 553 coronary patients.
      • Cardiovascular events were followed for up to 8 years.
      • High betatrophin protects from cardiovascular events and death.
      • Betatrophin was not associated with the presence or extent of atherosclerosis.

      Abstract

      Background and aims

      Betatrophin, also known as angiopoietin-like protein 8 (ANGPTL8) or lipasin, is a nutritionally-regulated mammalian-specific protein secreted by the liver and adipose tissue. Many conflicting data exist with respect to its association with type 2 diabetes mellitus (T2DM), insulin resistance, and lipid markers, but no data are available on its association with cardiovascular risk.

      Methods

      We measured betatrophin in 553 coronary patients undergoing coronary angiography for the evaluation of established or suspected stable coronary artery disease (CAD) and prospectively recorded cardiovascular events during a follow-up of up to 8 years.

      Results

      During follow-up, 201 patients suffered a cardiovascular event and 64 died from cardiovascular causes. High betatrophin (upper tertile) was significantly and inversely associated with cardiovascular events both univariately (HR = 0.64 [95%CI 0.47–0.87], p = 0.004) and after full adjustment including the status of CAD and T2DM (adj. HR = 0.55 [95%CI 0.40–0.76], p < 0.001). The inclusion of betatrophin into a basic prediction model for the cardiovascular event risk significantly improved the model performance (NRI = 0.728, p < 0.001).

      Conclusions

      This study is the first to show that betatrophin predicts cardiovascular events independently of conventional risk factors including the presence of CAD and T2DM.

      Graphical abstract

      Keywords

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