Association of serum complement C1q with cardiovascular outcomes among patients with acute coronary syndrome undergoing percutaneous coronary intervention

Qiu-Xuan Li; Xiao-Teng Ma; Qiao-Yu Shao; Zhi-Qiang Yang; Jing Liang; Li-Xia Yang; Dong-Mei Shi; Yu-Jie Zhou; Zhi-Jian Wang

doi:10.11909/j.issn.1671-5411.2022.12.001

Association of serum complement C1q with cardiovascular outcomes among patients with acute coronary syndrome undergoing percutaneous coronary intervention

J Geriatr Cardiol. 2022 Dec 28;19(12):949-959. doi: 10.11909/j.issn.1671-5411.2022.12.001.

Authors

Qiu-Xuan Li¹, Xiao-Teng Ma¹, Qiao-Yu Shao¹, Zhi-Qiang Yang¹, Jing Liang¹, Li-Xia Yang¹, Dong-Mei Shi¹, Yu-Jie Zhou¹, Zhi-Jian Wang¹

Affiliation

¹ Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China.

PMID: 36632200
PMCID: PMC9807401
DOI: 10.11909/j.issn.1671-5411.2022.12.001

Abstract

Objective: To determine the association of serum complement C1q levels with cardiovascular outcomes among patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), and evaluate the value of C1q modified by high-sensitivity C-reactive protein (hs-CRP) levels as an independent predictor.

Methods: As a single-center prospective observational study, we analyzed 1701 patients who had received primary or elective PCI for ACS at Beijing Anzhen Hospital, Capital Medical University, Beijing, China between June 1, 2016 and November 30, 2017. The associations of C1q modified by hs-CRP with major adverse cardiovascular events (MACE) were determined in survival analysis.

Results: Patients with the lowest C1q tertile had the highest cumulative risk of MACE (log-rank P = 0.007). In fully adjusted Cox regression models, stratifying the total population according to hs-CRP dichotomy, C1q was significantly associated with MACE in patients with hs-CRP levels less than 2 mg/L but not in those with 2 mg/L or more (P _interaction = 0.02). In patients with hs-CRP levels less than 2 mg/L, with the lowest C1q tertile as reference, the risk of MACE was reduced by 40.0% in the middle C1q tertile [hazard ratio (HR) = 0.600, 95% CI: 0.423-0.852, P = 0.004] and by 43.9% in the highest C1q tertile (HR = 0.561, 95% CI: 0.375-0.840, P = 0.005).

Conclusions: Serum complement C1q is significantly associated with cardiovascular outcomes in patients with ACS undergoing PCI, only when hs-CRP levels are less than 2 mg/L. This finding implicates the usefulness of C1q for the risk stratification in ACS patients with reduced systemic inflammation.