C-Peptide Levels May Predict Mortality in Angiography Patients

C-peptide in highest versus lowest tertile linked to increased all-cause, cardiovascular mortality

WEDNESDAY, Dec. 26 (HealthDay News) -- Higher levels of C-peptide, a pro-insulin cleavage product, is associated with all-cause and cardiovascular mortality in patients undergoing coronary angiography, according to a study published online Nov. 30 in Diabetes Care.

Nikolaus Marx, M.D., from the University Hospital Aachen in Germany, and colleagues assessed whether C-peptide was correlated with cardiovascular and total mortality in 2,306 patients participating in the Ludwigshafen Risk and Cardiovascular Health Study. Participants underwent coronary angiography at baseline (1997 to 2000).

During a mean follow-up of 7.6 years, the researchers noted 440 deaths (19.1 percent), of which 252 (10.9 percent) were attributable to cardiovascular causes. After adjustment for age and sex, C-peptide in the third versus the first tertile correlated with a hazard ratio of 1.46 for all-cause mortality and 1.58 for cardiovascular mortality. These hazard ratios remained significant (1.46 and 1.55, respectively) after further adjustment for common risk factors as well as markers of glucose metabolism. Higher levels of markers of endothelial dysfunction and atherosclerosis as well as a more severe extent of coronary lesions were also seen in patients in higher tertiles of C-peptide.

"Taken together, our study suggests that elevated levels of C-peptide are predictive of both all-cause as well as cardiovascular mortality in patients undergoing coronary angiography and raises the hypothesis that C-peptide could potentially play a causal role in atherogenesis in humans," the authors write.

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