Abstract 9149: The Novel Wnt-Pathway Inhibitor Podocan is Not Associated with All-Cause Mortality or Cardiovascular Outcome in Patients Admitted with Suspected Acute Coronary Syndrome

Abstract

Introduction: Podocan, a novel extracellular matrix glycoprotein, is a smooth muscle cell regulator and abundantly expressed in human atheroma. The association of Podocan with cardiovascular outcome remains unclear. The aim of this study was to assess the predictive value of Podocan concerning adverse outcome in patients admitted with acute chest pain suspected to be acute coronary syndrome (ACS). Methods: Plasma Podocan was measured with an enzyme immune assay in samples taken upon hospital admission from patients with suspected ACS who were enrolled in the Risk markers in Acute Coronary Syndrome (RACS) study (NCT00521976). RACS was a Norwegian single center study including patients from November 2002 to September 2003. The primary outcome was a composite of all-cause mortality, myocardial infarction, or stroke within 7 years. Additional analyzes included these individual components at 1, 2, and 7 years, and cardiac death at 1 and 2 years. Associations between quartiles of Podocan and the primary outcome, its individual components, and cardiac death were assessed in both univariate analyzes and in stepwise multivariable Cox regression analyzes fitted with significant clinical variables, past medical history, medication, TnT, BNP, and eGFR before Podocan was introduced. Results: Samples were available from 815 patients (mean age: 69.6 years, male: 61.3%, elevated TnT: 53.0%). Mean Podocan level was 1.03 ng/mL (CI 0.93-1.13). Podocan was neither associated with the primary composite endpoint within 7 years in univariate analyzes (X 2 analyzes (p=0.426), AUROC 0.518 (p=0.374), Kaplan Meier analyzes (log-rank test p=0.594), and Cox regression (p=0.595)), nor in multivariable Cox regression analyzes (p=0.744). Similar results were found by analyzes of the individual components of the primary outcome and of cardiac death for all time points, as well as in subgroup analyzes of patients with elevated TnT (p>0.05 for all). Conclusions: This first report in the literature on Podocan in acute chest pain did not reveal any significant predictive value of this novel wnt-pathway inhibitor concerning the combination of all-cause death, MI, or stroke, its individual components or cardiac death in patients admitted with suspected ACS, irrespective of TnT status.