MGUS Predicts Worse Prognosis in Patients with Coronary Artery Disease
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ORIGINAL ARTICLE
MGUS Predicts Worse Prognosis in Patients with Coronary Artery Disease Zhao Xu 1 & Yifeng Sun 1 & Tianhong Xu 1 & Yidan Shi 2 & Lifan Liang 1 & Peng Liu 1 & Junbo Ge 3 Received: 28 July 2019 / Accepted: 11 December 2019 # The Author(s) 2020
Abstract We performed a retrospective cohort study to analyze all 87 CAD patients with MGUS and 178 CAD patients without MGUS admitted in Zhongshan Hospital Fudan University from 2015 to 2017. Patients were followed up via regular patient visits or telephone, and the median follow-up period was 2.9 years. The end point of follow-up was the occurrence of major adverse cardiac events (MACE). CAD patients with MGUS had a higher risk of MACE than those without MGUS (log-rank P = 0.0015). After adjustment for other markers in the stepwise Cox regression model, MGUS was still related to the increasing risk of MACE incident (P = 0.002, HR = 2.308). Then, we constructed the nomogram based on the Cox regression model, and the concordance index (C-index) was 0.667. Hence, MGUS might be added into the risk model of CAD. Keywords MGUS . Prognosis . Coronary artery disease . Nomogram
Abbreviation CAD coronary artery disease MGUS monoclonal gammopathy of undetermined significance MACE major adverse cardiac events C-index concordance index MM multiple myeloma
Zhao Xu and Yifeng Sun contributed equally to this work. Associate Editor Angela Taylor oversaw the review of this article Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12265-019-09950-w) contains supplementary material, which is available to authorized users. * Peng Liu [email protected] 1
Department of Hematology, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai 200032, China
2
Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Canada
3
Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan University, Shanghai, China
WM SPEP IFE FLC eGFR cTNT LDL CRP NT-proBNP APTT PT AIC HR NRI IDI
Waldenström macroglobulinemia serum protein electrophoresis immunofixation electrophoresis free light chain estimated glomerular filtration rate cardiac troponin T low-density lipoprotein C-reactive protein N-terminal pro-brain natriuretic peptide activated partial thromboplastin time prothrombin time Akaike information criterion hazard ratios net reclassification improvement integrated discrimination improvement
Introduction Plasma cell disorders, also called monoclonal gammopathy, are verified to be premalignant and malignant disorders characterized by monoclonal proteins secreted by clonal plasma cells and immunological homogeneity on electrophoresis. Plasma cell disorders consist of many pathological conditions, including monoclonal gammopathy of undetermined significance (MGUS), solitary plasmacytoma, multiple myeloma (MM), amyloidosis, Waldenström macroglobulinemia (WM), and POEMS syndrome. Among them, MGUS is the
J. of Cardiovasc. Trans. Res.
most common disease. According t
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