Evaluation of Coronary Artery Calcification and Gremlin-1 Serum Level Correlation in Patients with Chronic Ischemic Heart Disease

Abstract

Background: Available evidences have shown that bone morphogenetic proteins (BMPs), particularly BMP 2 and BMP 4, are involved in vascular calcification. Gremlin 1 is one of the important endogenous inhibitors of BMPs. This extracellular antagonist of bone morphogenic proteins has a very complex and cysteine-rich chain and establishes non-colonial transmissions to the members of the family with varying degrees of dependence and prevents them from binding to the receptor, thereby inhibit their function. The main objective of this study was clinical evaluation of the correlation between Gremlin-1 serum concentration and Coronary Artery Calcification. Methods: Eighty-four patients with coronary artery disease from cardiology ward of Razavi Hospital, Mashhad, Iran, who completed the inclusion criteria, entered in the study between November 2015 and March 2016. CT-Angiography was performed to define coronary artery calcium score and Gremlin-1 serum concentrations were measured by an ELISA kit. Results: Eighty-one patients, with mean age of 57.19±10.18 years were included to the study. The mean serum level of Gremlin-1 was 10.92±8.46 pg/mL. There was a reverse significant correlation between Gremlin-1 serum concentration and Coronary Artery Calcification of Right coronary artery(RCA) (P<0.05), in contrast to total Coronary Artery Calcification score, left artery Descending (LAD), Left Main (LM) and Circumflex (CX). However, there was no evidence that age and sex risk factor, hypertension, diabetes mellitus, hyperlipidemia, positive family history, current smoking and high BMI to be associated with serum level of Gremlin-1. Conclusion: Based on the results, Gremlin-1 serum concentration may be a suitable biomarker for predication coronary artery calcification severity. However, more researches on larger population are necessary for its validation.