{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:16:30Z","timestamp":1793132190867,"version":"4.5.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2013,1,23]]},"abstract":"\n Background<\/jats:title>\n \n In acute coronary syndromes,\n C<\/jats:styled-content>\n \u2010reactive protein (\n CRP<\/jats:styled-content>\n ) strongly relates to subsequent death, but surprisingly not to recurrent myocardial infarction. Other biomarkers may reflect different processes related to these outcomes. We assessed 8 inflammatory and vascular biomarkers and the risk of death and recurrent nonfatal cardiovascular events in the 16\u00a0weeks after an acute coronary syndrome.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We measured blood concentrations of\n CRP<\/jats:styled-content>\n , serum amyloid\n A<\/jats:styled-content>\n (\n SAA<\/jats:styled-content>\n ), interleukin\u20106 (\n IL<\/jats:styled-content>\n \u20106), soluble intercellular adhesion molecule (\n ICAM<\/jats:styled-content>\n ), soluble vascular cell adhesion molecule (\n VCAM<\/jats:styled-content>\n ),\n E<\/jats:styled-content>\n \u2010selectin,\n P<\/jats:styled-content>\n \u2010selectin, and tissue plasminogen activator antigen (\n tPA<\/jats:styled-content>\n ) 24 to 96\u00a0hours after presentation with acute coronary syndrome in 2925 subjects participating in a multicenter study. Biomarkers were related to the risk of death, and recurrent nonfatal acute coronary syndromes (myocardial infarction or unstable angina) over 16\u00a0weeks using\n C<\/jats:styled-content>\n ox proportional hazard models. On univariate analyses, baseline\n CRP<\/jats:styled-content>\n (\n P<\/jats:italic>\n =0.006), SAA (\n P<\/jats:italic>\n =0.012), and IL\u20106 (\n P<\/jats:italic>\n <0.001) were related to death, but not to recurrent nonfatal acute coronary syndromes.\n VCAM<\/jats:styled-content>\n and\n tPA<\/jats:styled-content>\n related to the risk of death (\n P<\/jats:italic>\n <0.001,\n P<\/jats:italic>\n =0.021, respectively) and to nonfatal acute coronary syndromes (\n P<\/jats:italic>\n =0.021,\n P<\/jats:italic>\n =0.049, respectively). Adjusting for significant covariates reduced the strength of the associations; however,\n CRP<\/jats:styled-content>\n and\n SAA<\/jats:styled-content>\n continued to relate to death.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In acute coronary syndromes, the\n CRP<\/jats:styled-content>\n inflammatory axis relates to the risk of death and may reflect myocardial injury.\n VCAM<\/jats:styled-content>\n and\n tPA<\/jats:styled-content>\n may have greater specificity for processes reflecting inflammation and thrombosis in the epicardial arteries, which determine recurrent coronary events.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.112.003103","type":"journal-article","created":{"date-parts":[[2013,5,24]],"date-time":"2013-05-24T16:49:11Z","timestamp":1369414151000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":70,"title":["Inflammatory Biomarkers, Death, and Recurrent Nonfatal Coronary Events After an Acute Coronary Syndrome in the MIRACL Study"],"prefix":"10.1161","volume":"2","author":[{"given":"Payman","family":"Zamani","sequence":"first","affiliation":[{"name":"Cardiovascular Division, University of California, San Diego, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory G.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Cardiology Division, Veterans Affairs Medical Center and University of Colorado, Denver, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders G.","family":"Olsson","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Link\u00f6ping, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Rifai","sequence":"additional","affiliation":[{"name":"Children's Hospital Boston and Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihang","family":"Bao","sequence":"additional","affiliation":[{"name":"Pfizer Pharmaceuticals Group, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Libby","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ganz","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, San Francisco General Hospital and University of California, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Kinlay","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA"},{"name":"Cardiovascular Division, Veterans Affairs Boston Healthcare System, West Roxbury, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study 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