Wenjie Yin1,2,3,4, Fengjuan Li3,4, Xin Tan3,4, Huimin Wang1,3,4, Wenxi Jiang3,4, Xue Wang3,4, Sijin Li2,5, Yanbo Zhang6, Qinghua Han2, Yuan Wang3,4, Jie Du1,3,4,5. 1. Key Laboratory of Cellular Physiology, Ministry of Education, and the Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi Province, China. 2. The First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China. 3. Beijing Collaborative Innovation Center for Cardiovascular Disorders, the Key Laboratory of Remodeling-Related Cardiovascular Disease, Ministry of Education, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 4. Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China. 5. Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, Shanxi Province, China. 6. Department of Health Statistics, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi Province, China.
Abstract
BACKGROUND: Plasma ceramides (Cer) have been used to evaluate risk of cardiovascular (CV) events in patients with coronary heart disease. We investigated the performance of ceramides and ceramide score (CERT) in hypertensive patients at high CV risk. METHODS: Seven ceramides were analyzed using ultra-performance liquid chromatography-tandem mass spectrometry in 920 essential hypertension patients at high CV risk, who visited Beijing Anzhen Hospital from September 2016 to September 2018 (median age: 49 years, 562 males). All patients were followed up for major adverse cardiovascular events (MACE), which included incident acute coronary syndrome, heart failure, stroke, and CV death. RESULTS: During mean 2.3-year follow-up, 71 patients experienced MACE. Cer(d18:1/16:0), Cer(d18:1/22:0), and Cer(d18:1/24:0) were highly significant in predicting MACE [multiadjusted hazard ratios (95% confidence interval, CI) per SD were 1.76 (1.34-2.30), 0.55 (0.41-0.73), and 0.66 (0.47-0.92), respectively]. Compared with traditional variables (comprising presence of CV risk factors, hypertension-mediated organ damage, and comorbidities), a novel CERT for hypertensive patients (CERT-HBP), composed of Cer(d18:1/16:0), Cer(d18:1/24:1), and their ratios to Cer(d18:1/24:0) and Cer(d18:1/22:0), respectively, increased the C-statistic from 0.751 (95% CI, 0.697-0.806) to 0.791 (95% CI, 0.737-0.845), P = 0.010. Net reclassification improvement and integrated discrimination improvement were 0.648 (95% CI, 0.421-0.885, P < 0.001) and 0.046 (95% CI, 0.025-0.068, P < 0.001), respectively. CONCLUSIONS: A ceramide-based CERT-HBP was established to evaluate risk of MACE in hypertensive patients at high CV risk. This may improve identification of high-risk patients requiring increased attention and aggressive therapy. CLINICAL TRIALS REGISTRATION: Trial Number NCT03708601.
BACKGROUND: Plasma ceramides (Cer) have been used to evaluate risk of cardiovascular (CV) events in patients with coronary heart disease. We investigated the performance of ceramides and ceramide score (CERT) in hypertensive patients at high CV risk. METHODS: Seven ceramides were analyzed using ultra-performance liquid chromatography-tandem mass spectrometry in 920 essential hypertension patients at high CV risk, who visited Beijing Anzhen Hospital from September 2016 to September 2018 (median age: 49 years, 562 males). All patients were followed up for major adverse cardiovascular events (MACE), which included incident acute coronary syndrome, heart failure, stroke, and CV death. RESULTS: During mean 2.3-year follow-up, 71 patients experienced MACE. Cer(d18:1/16:0), Cer(d18:1/22:0), and Cer(d18:1/24:0) were highly significant in predicting MACE [multiadjusted hazard ratios (95% confidence interval, CI) per SD were 1.76 (1.34-2.30), 0.55 (0.41-0.73), and 0.66 (0.47-0.92), respectively]. Compared with traditional variables (comprising presence of CV risk factors, hypertension-mediated organ damage, and comorbidities), a novel CERT for hypertensive patients (CERT-HBP), composed of Cer(d18:1/16:0), Cer(d18:1/24:1), and their ratios to Cer(d18:1/24:0) and Cer(d18:1/22:0), respectively, increased the C-statistic from 0.751 (95% CI, 0.697-0.806) to 0.791 (95% CI, 0.737-0.845), P = 0.010. Net reclassification improvement and integrated discrimination improvement were 0.648 (95% CI, 0.421-0.885, P < 0.001) and 0.046 (95% CI, 0.025-0.068, P < 0.001), respectively. CONCLUSIONS: A ceramide-based CERT-HBP was established to evaluate risk of MACE in hypertensive patients at high CV risk. This may improve identification of high-risk patients requiring increased attention and aggressive therapy. CLINICAL TRIALS REGISTRATION: Trial Number NCT03708601.
Authors: Sonia Borodzicz-Jażdżyk; Piotr Jażdżyk; Wojciech Łysik; Agnieszka Cudnoch-Jȩdrzejewska; Katarzyna Czarzasta Journal: Front Cardiovasc Med Date: 2022-08-31