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Elevated concentration of placental growth factor ( PlGF ) and long term risk in patients with acute coronary syndrome in the PROVE IT-TIMI 22 trial . Placental growth factor ( PlGF ) , a member of the vascular endothelial growth factor ( VEGF ) family , acts via the flt-1 receptor and promotes endothelial activation and macrophage recruitment into atherosclerotic lesions . We investigated the relationship of PlGF with cardiovascular outcomes in a large cohort of patients presenting across the spectrum of ACS . PlGF was measured at baseline ( n = 3,761 ) and at four-months ( n = 3,369 ) in patients randomized to atorvastatin 80 mg or pravastatin 40 mg after ACS in the PROVE IT-TIMI 22 trial . The primary endpoint was death , myocardial infarction ( MI ) , unstable angina , revascularization or stroke ( mean follow-up 24 months ) . Elevated baseline PlGF was associated with a higher incidence of the primary endpoint through 2 years ( Q1 vs. Q5 : 18.7 vs. 29.3 % , p < 0.0001 ) . The risk of death or MI was also higher in patients with elevated baseline PlGF ( Q1 vs. Q5 : 7.0 vs. 11.6 % , p = 0.029 ) . Adjusting for baseline characteristics and risk factors , elevated baseline PlGF was independently associated with the risk of the primary endpoint ( adjusted-HR for Q5 vs. Q1 1.45 ; 95 % CI 1.16-1.83 ; p = 0.001 ) . Elevated PlGF at four months was associated with higher risk of death or MI ( Adjusted HR Q5 vs. Q1 2.79 , 95 % CI : 1.37-5.68 ; p = 0.005 ) , and higher risk of the primary endpoint ( Adjusted HR Q5 vs. Q1 1.78 , 95 % CI : 1.26-2.51 ; p = 0.001 ) . Higher concentration of PlGF after ACS is associated with long-term risk of recurrent cardiovascular events independent of traditional risk factors . This association is present early after ACS and appears to be stronger at four months .
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Intervention_Physical
Placental growth factor
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Intervention_Pharmacological
atorvastatin 80 mg or pravastatin 40 mg after ACS
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Outcome_Physical
Placental growth factor ( PlGF )
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Outcome_Pain
PlGF
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Outcome_Mortality
death
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Outcome_Physical
, myocardial infarction ( MI ) , unstable angina , revascularization or stroke
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Outcome_Other
risk of
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Outcome_Mortality
death
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Outcome_Other
or
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Outcome_Physical
MI
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Outcome_Mortality
risk of death
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Outcome_Other
or
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Outcome_Physical
MI
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Outcome_Physical
PlGF