Italy: Mannose as a Biomarker of Coronary Artery Disease

Data from research published in the International Journal of Cardiology adds novel evidence that high circulating mannose is a biomarker of coronary artery disease (CAD) that is consistent across measures of severity of vessel involvement and independent of the traditional correlates of CVD. Furthermore, baseline mannose also had some predictive power for incident clinical events despite the small number of cardiovascular outcomes.

"High mannose might be a signature of CAD with a vulnerable plaque phenotype," Ele Ferrannini, CNR Institute of Clinical Physiology, Pisa, Italy, and colleagues wrote in their study. "And, high mannose was an independent predictor of adverse outcomes."

Previous studies have shown high mannose to be associated with insulin resistance and cardiovascular disease (CVD). Dr. Ferrannini and the team aimed to establish whether mannose is associated with anatomical evidence of CAD.

For this purpose, the researchers measured plasma mannose concentrations by liquid chromatography/tandem mass spectrometry in a discovery cohort (n = 513) and a validation cohort (n = 221) of carefully phenotyped individuals. In both cohorts, state-of-the-art imaging techniques (coronary computed coronary tomography angiography (CCTA), invasive coronary angiography, and optical coherence tomography) were used to quantitate CAD.

Associations of mannose with angiographic variables and biomarkers were also tested. Using the Kaplan-Meier estimator, survival analysis was performed.

Study Findings

• Mannose was related to indices of CAD and features of plaque vulnerability.
• In the discovery cohort, mannose was a marker of quantity and quality of CCTA-proven CAD, and subjects with a mannose level in the top quartile had a significantly higher risk of CVD events/death.
• In the validation cohort, mannose was significantly associated with fibrous cap thickness < 65 μm (odds ratio = 1.32 per each 10 μmol/L mannose change) and was an independent predictor of death (hazard ratio for mannose ≥ vs < 84.6 μmol/L: 4.0).

To conclude, the results showed novel evidence that high mannose is a signature of CAD with a vulnerable plaque phenotype, consistently across measures of severity of vessel involvement and independent of the traditional CVD correlates, and that it is an independent predictor of incident adverse outcomes.

Reference

The study titled, "Mannose as a biomarker of coronary artery disease: Angiographic evidence and clinical significance," was published in the International Journal of Cardiology.

DOI: https://doi.org/10.1016/j.ijcard.2021.11.038