Background: Placenta growth factor (PlGF), a member of the vascular endothelial growth factor family, promotes neoarteriogenesis and triggers intraplaque inflammation thereby stimulating atherosclerotic plaque progression and plaque rupture.
Objective: To investigate prognostic significance of circulating placenta growth factor (PlGF) in coronary artery disease (CAD) patients.
Methods: 78 patients, aged 44-81 years (mean age 61.6+/-13.1 years) with acute myocardial infarction (AMI) (n=19), unstable angina (UA) (n=23), stable effort angina (n=23), and with no evidence of CAD (n=13) were followed-up for at least 48 months. Death, AMI, any revascularization, and hospitalization for UA or progressive effort angina were considered as end points. Plasma levels of PlGF, C-reactive protein (CRP), interleukin-6 (IL-6), neopterin, tumor necrosis factor alpha (TNF-a), haptoglobin and homocysteine were measured at primary admission.
Results: During follow up (617+/-263 days) 3 deaths, 1 nonfatal AMI, 4 UA, and 7 angina progression related hospitalizations occurred. Mean event-free survival periods differed significantly between subgroups of patients with low (<7.5 pg/ml), medium (7.5-20.5 pg/ml), and high (>20.5 pg/ml) PlGF levels (1038+/-56, 729+/-55, and 578+/-63 days, respectively). Logrank survival in patients with low PlGF was significantly better than in high PlGF subgroup (p=0.038). PlGF levels did not correlate with age, lipid levels, blood pressure and smoking. A significant positive correlation was found between PlGF and haptoglobin (r=0.34, p=0.028), homocysteine (r=0.455, p=0.044), neopterin (r=0.31, p=0.048), and carotid intima-media thickness.
Conclusion: Elevated PlGF plasma levels predict worse prognosis in CAD patients; PlGF levels correlate with haptoglobin, neopterin, and homocysteine blood levels and with the carotid artery intima-media thickness.