Amyloid-Beta (1–40) Strong Predictor of Mortality in Acute Coronary Syndrome

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Measurement of blood levels of amyloid-beta (1–40) can predict subsequent mortality in patients presenting with non-ST-segment-elevation acute coronary syndrome, according to a study in the Annals of Internal Medicine. Amyloid-beta (1–40) is a peptide that appears to have proinflammatory and prothrombotic properties.

Using blood samples, researchers retrospectively measured baseline amyloid-beta (1–40) levels in two cohorts comprising nearly 1900 adults with unstable angina or non-ST-elevation myocardial infarction. During a median follow-up of roughly 2 years, 195 patients died. Those in the highest tertile of amyloid-beta (1–40) were over 50% more likely to die from any cause than those in the lower tertiles, even after adjustment for traditional risk factors and the guideline-recommended GRACE score (which incorporates age, heart rate, and cardiac arrest, among other variables).

Of note, amyloid-beta (1–40) generally classified a patient's mortality risk better than the GRACE score.

Dr. Harlan Krumholz of NEJM Journal Watch Cardiology cautions, "For a new biomarker to make it into practice, we need some demonstration of the value of the information — and some proof that its use can improve patient outcomes or reduce costs, or even both."