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Clinical impact of admission urinary 8-hydroxydeoxyguanosine level for predicting cardiovascular mortality in patients with acute coronary syndrome

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Abstract

The aim of the present study was to determine whether urinary 8-hydroxydeoxyguanosine (8-OHdG), which is a marker of oxidative stress, can predict future cardiovascular death in patients with acute coronary syndrome (ACS). A total of 551 consecutive patients with ACS who underwent admission urinary 8-OHdG measurements were enrolled in this study. The patients were divided into 2 groups according to the optimal cutoff value of admission urinary 8-OHdG determined by a receiver-operating characteristics curve for the prediction of cardiovascular death: a high admission urinary 8-OHdG group, 169 patients with admission urinary 8-OHdG ≥ 17.92 ng/mg creatinine; and a low admission urinary 8-OHdG group, 382 patients with admission urinary 8-OHdG < 17.92 ng/mg creatinine. The patients were followed up for a median period of 34 months. The primary and secondary end points were the incidence of cardiovascular death and major cardiovascular events (MACE) composed of cardiovascular death, non-fatal myocardial infarction, or urgent hospitalization for heart failure. Of the 551 patients, cardiovascular deaths and MACE occurred in 14 (2.5%) and 35 (6.4%), respectively. The Kaplan–Meier estimate of the event-free rate revealed cardiovascular deaths and MACE were more likely in the high admission 8-OHdG group than in the low admission 8-OHdG group (log rank, both P < 0.001). Multiple adjusted Cox proportional hazards analysis indicated that high admission urinary 8-OHdG was an independent predictor of cardiovascular death (hazard ratio [HR] 7.642, P = 0.011) and MACE (HR 2.153, P = 0.049). High admission urinary 8-OHdG levels predict cardiovascular mortality after adjustment in patients with ACS.

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Acknowledgments

Funding was provided by Astellas, Astra Zeneca, Boehringer Ingelheim, Daiichi Sankyo, Eisai, Kowa, Kyowa Hakko Kirin, Merck, Mitsubishi Tanabe, Ono, Otsuka, Pfizer, Sanofi Aventis, Shionogi, Sumitomo Dainippon, Takeda, and Terumo.

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Authors and Affiliations

  1. Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan

    Masaomi Gohbara, Noriaki Iwahashi, Hidefumi Nakahashi, Shunsuke Kataoka, Hironori Takahashi, Jin Kirigaya, Yugo Minamimoto, Eiichi Akiyama, Kozo Okada, Yasushi Matsuzawa, Masaaki Konishi, Nobuhiko Maejima, Kiyoshi Hibi, Masami Kosuge, Toshiaki Ebina & Kazuo Kimura

  2. Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Masaomi Gohbara, Masaaki Konishi, Teruyasu Sugano, Toshiyuki Ishikawa, Kouichi Tamura & Kazuo Kimura

  3. Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, Yokohama, Japan

    Toshiaki Ebina

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  1. Masaomi Gohbara
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  2. Noriaki Iwahashi
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Correspondence to Masaomi Gohbara.

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Conflict of interest

Dr. Kimura reports receiving research grant support from Astellas, Astra Zeneca, Boehringer Ingelheim, Daiichi Sankyo, Eisai, Kowa, Kyowa Hakko Kirin, Merck, Mitsubishi Tanabe, Ono, Otsuka, Pfizer, Sanofi Aventis, Shionogi, Sumitomo Dainippon, Takeda, and Terumo.

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Gohbara, M., Iwahashi, N., Nakahashi, H. et al. Clinical impact of admission urinary 8-hydroxydeoxyguanosine level for predicting cardiovascular mortality in patients with acute coronary syndrome. Heart Vessels 36, 38–47 (2021). https://doi.org/10.1007/s00380-020-01663-4

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  • DOI: https://doi.org/10.1007/s00380-020-01663-4

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