Effect of Serum Carboxyl-Terminal Telopeptide of Type I Collagen on Clinical Outcomes in Patients With Coronary Artery Disease.

Background: Coronary artery disease (CAD) is a major cause of mortality worldwide. Serum carboxyl-terminal telopeptide of type I collagen (CITP), a marker of collagen degradation in the heart and blood vessels, is associated with plaque vulnerability and cardiac remodeling in patients with acute myocardial infarction. However, the effect of CITP on the clinical outcomes of patients with CAD has not yet been elucidated.

Methods And Results: Serum CITP concentrations were measured in 621 consecutive patients with CAD. All patients were prospectively followed up for a median period of 1,554 days. The primary endpoint was a composite of hospitalization for heart failure or cardiovascular death; the secondary endpoints were all-cause death and heart failure rehospitalization. B-Type natriuretic peptide and the left ventricular mass index were higher in the highest CITP tertile group. Kaplan-Meier analysis demonstrated that the CAD patients in the highest CITP tertile group had the greatest risk of both primary and secondary endpoints, independent of acute or chronic coronary syndrome. Multivariate Cox proportional hazard regression analysis demonstrated that CITP was an independent predictor of both primary and secondary endpoints after adjusting for confounding risk factors, regardless of acute or chronic coronary syndrome.

Conclusions: The serum CITP concentration could be a feasible marker for clinical outcomes in patients with CAD.