TY - JOUR
T1 - Blood acetylcholinesterase activity is associated with increased 10 year all-cause mortality following coronary angiography
AU - Shenhar-Tsarfaty, Shani
AU - Brzezinski, Rafael Y.
AU - Waiskopf, Nir
AU - Finkelstein, Ariel
AU - Halkin, Amir
AU - Berliner, Shlomo
AU - Rogowski, Ori
AU - Zeltser, David
AU - Shapira, Itzhak
AU - Laufer-Perl, Michal
AU - Shacham, Yacov
AU - Litmanowicz, Batia
AU - Banai, Shmuel
AU - Soreq, Hermona
AU - Arbel, Yaron
N1 - Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/11
Y1 - 2020/11
N2 - Background and aims: Parasympathetic dysfunction is associated with increased risk for major adverse cardiovascular events (MACE). However, clinically validated biomarkers that reflect parasympathetic activity are not yet available. We sought to assess the ability of serum cholinesterase activity to predict long term survival in patients undergoing coronary angiography. Methods: We prospectively followed 1002 consecutive patients undergoing clinically indicated coronary angiography (acute coronary syndrome or stable angina). We measured blood acetylcholinesterase (AChE) activity using the acetylcholine analog acetylthiocholine. Mortality rates were determined up to 10 years of follow-up. We divided our cohort into 3 groups with low, intermediate and high AChE activity by a Chi-square automatic interaction detection method (CHAID). Results: Patients with lower than cutoff levels of AChE (<300 nmol/min/ml) had higher mortality rates over 10 years of follow-up, after adjusting for conventional risk factors, biomarkers, clinical indication, and use of medications (HR = 1.6, 95% CI 1.1–2.5, p = 0.02). Patients with intermediate levels of AChE (300–582 nmol/min/ml) were also at increased risk for death (HR = 1.4, 95% CI 1.1–1.9, p = 0.02). AChE was inversely correlated with C-reactive protein, troponin I, fibrinogen and neutrophil/lymphocyte ratio levels. Conclusions: Patients presenting for coronary angiography with low levels of serum AChE activity are at increased risk for death during long term follow-up.
AB - Background and aims: Parasympathetic dysfunction is associated with increased risk for major adverse cardiovascular events (MACE). However, clinically validated biomarkers that reflect parasympathetic activity are not yet available. We sought to assess the ability of serum cholinesterase activity to predict long term survival in patients undergoing coronary angiography. Methods: We prospectively followed 1002 consecutive patients undergoing clinically indicated coronary angiography (acute coronary syndrome or stable angina). We measured blood acetylcholinesterase (AChE) activity using the acetylcholine analog acetylthiocholine. Mortality rates were determined up to 10 years of follow-up. We divided our cohort into 3 groups with low, intermediate and high AChE activity by a Chi-square automatic interaction detection method (CHAID). Results: Patients with lower than cutoff levels of AChE (<300 nmol/min/ml) had higher mortality rates over 10 years of follow-up, after adjusting for conventional risk factors, biomarkers, clinical indication, and use of medications (HR = 1.6, 95% CI 1.1–2.5, p = 0.02). Patients with intermediate levels of AChE (300–582 nmol/min/ml) were also at increased risk for death (HR = 1.4, 95% CI 1.1–1.9, p = 0.02). AChE was inversely correlated with C-reactive protein, troponin I, fibrinogen and neutrophil/lymphocyte ratio levels. Conclusions: Patients presenting for coronary angiography with low levels of serum AChE activity are at increased risk for death during long term follow-up.
KW - Biomarkers
KW - Cholinesterase
KW - Coronary angiography
KW - Coronary artery disease
KW - Parasympathetic dysfunction
UR - http://www.scopus.com/inward/record.url?scp=85092236650&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2020.10.004
DO - 10.1016/j.atherosclerosis.2020.10.004
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C2 - 33049656
AN - SCOPUS:85092236650
SN - 0021-9150
VL - 313
SP - 144
EP - 149
JO - Atherosclerosis
JF - Atherosclerosis
ER -