Abstract
Background: Chromogranin B (CgB) is increased in heart failure and proportionate to disease severity. We investigated whether circulating CgB level is associated with left ventricular (LV) functional recovery potential after successful recanalization of chronic total occlusion (CTO).Methods: Serum levels of CgB were assayed in 53 patients with stable angina with LV functional recovery [an absolute increase in LV ejection fraction (EF) of ≥5%] and 53 age- and sex-matched non-recovery controls after successful recanalization of CTO during 12-month follow-up.Results: We found that CgB level was significantly lower in the recovery group than in the non-recovery group (593 [IQR 454–934] vs. 1,108 [IQR 696–2020] pg/ml, P < 0.001), and that it was inversely correlated with changes in LVEF (Spearman's r = −0.31, P = 0.001). Receiver operating characteristic (ROC) analysis showed that the area under the curve of CgB for predicting LVEF improvement was 0.76 (95% CI 0.664–0.856), and that the optimal cutoff value was 972.5 pg/ml. In multivariate analyses, after adjusting for confounding factors, high CgB level remained an independent determinant of impaired LV functional recovery after CTO recanalization. LV functional improvement appeared to be more responsive to CgB in patients with poor than with good coronary collaterals.Conclusions: Elevated circulating CgB level confers an increased risk of impaired LV functional recovery after successful recanalization of CTO in patients with stable coronary artery disease.
Highlights
Chronic total occlusion (CTO) occurs in 18–31% of patients with significant coronary artery disease undergoing routine coronary angiography [1,2,3]
We found that Chromogranin B (CgB) level was significantly lower in the recovery group than in the non-recovery group (593 [IQR 454–934] vs. 1,108 [IQR 696–2020] pg/ml, P < 0.001), and that it was inversely correlated with changes in LV ejection fraction (LVEF) (Spearman’s r = −0.31, P = 0.001)
Receiver operating characteristic (ROC) analysis showed that the area under the curve of CgB for predicting LVEF improvement was 0.76, and that the optimal cutoff value was 972.5 pg/ml
Summary
Chronic total occlusion (CTO) occurs in 18–31% of patients with significant coronary artery disease undergoing routine coronary angiography [1,2,3]. Both randomized trials and observational studies have demonstrated that successful revascularization of CTO lesions accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass grafting is associated with a number of clinical benefits, such as anginal symptom relief, improved quality of life and left ventricular (LV) function, and decreased mortality when compared to CTO patients whose recanalization failed or those who received optimal medical treatment only [4,5,6,7]. We investigated whether circulating CgB level is associated with left ventricular (LV) functional recovery potential after successful recanalization of chronic total occlusion (CTO)
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