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Elevated levels of DNA particles, including markers of cell death and formation of neutrophil extracellular traps, may help physicians predict CV risk and identify CAD in patients with chest discomfort, according to study results.
“The more the ongoing cell death, which is normal with inflammation, the more DNA enters the circulation and more plaque builds up,” study researcher Julian I. Borissoff, MD, PhD, a postdoctoral fellow at Boston Children’s Hospital and Harvard Medical School, said in a press release. “Cells get damaged, and the products released from the damaged cells can cause even more damage and inflammatory responses.”
Borissoff and colleagues examined a prospective, observational, cross-sectional cohort of 282 patients aged 34 to 83 years with chest pain and suspected CAD. The researchers used coronary CT angiography (CCTA) to assess the severity, extent and phenotype of coronary atherosclerosis. Blood samples also were collected and underwent DNA analysis. The occurrence of major adverse cardiac events, including revascularization more than 60 days after CCTA with PCI or CABG, ACS and cardiac mortality, served as the composite endpoint.
Results revealed significantly elevated plasma double-stranded DNA, nucleosomes and myeloperoxidase (MPO)-DNA complexes in patients with severe coronary atherosclerosis or with extreme coronary artery calcification. After adjustment for confounding factors, data from a multinomial regression analysis showed that high plasma nucleosome levels were independently associated with an increased risk for severe coronary stenosis (OR=2.14; 95% CI, 1.26-3.63). The researchers also found that neutrophil extracellular trap markers, including MPO-DNA complexes, served as independent predictors of the number of atherosclerotic coronary vessels and the occurrence of major adverse cardiac events.
These data may be clinically meaningful in helping physicians predict CV risk using these biomarkers, according to the researchers.
“If those markers are proven to be effective — specific and sensitive — they may improve medical care in terms of identifying patients at risk sooner, and so the patients may go on treatment sooner,” Borissoff said.
The researchers said larger and longer studies are required to understand the role of neutrophil extracellular traps in the development of atherosclerosis and atherothrombosis.
Disclosure: The researchers report no relevant financial disclosures.
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