Prognostic impacts of Rho-kinase activity in circulating leucocytes in patients with vasospastic angina

Taro Nihei, Jun Takahashi, Kiyotaka Hao, Yoku Kikuchi, Yuji Odaka, Ryuji Tsuburaya, Kensuke Nishimiya, Yasuharu Matsumoto, Kenta Ito, Satoshi Miyata, Yasuhiko Sakata, Hiroaki Shimokawa

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25 Citations (Scopus)


Aims Rho-kinase activity in circulating leucocytes is a useful biomarker for diagnosis and disease activity assessment of vasospastic angina (VSA). The present study aimed to examine the long-term prognostic impact of Rho-kinase activity in circulating leucocytes in VSA patients. Methods and results We prospectively enrolled 174 consecutive patients with VSA and 50 non-VSA patients, in whom we measured Rho-kinase activity in circulating leucocytes, and they were followed for a median of 16 months. The primary endpoint was cardiac events including cardiac death, non-fatal myocardial infarction, and hospitalization for unstable angina. During the follow-up period, cardiac events occurred in 10 VSA patients (5.7%) but in none of the nonVSA patients. When we divided VSA patients into two groups by a median value of their Rho-kinase activity, the Kaplan-Meier survival analysis showed a significantly worse prognosis in VSA patients with high Rho-kinase activity compared with those with low activity or non-VSA patients (log-rank; P < 0.05, respectively). Receiver-operating characteristic curve analysis showed that Rho-kinase activity value of 1.24 was the best cut-off level to predict cardiac events in VSA patients, and multivariable analysis showed that a value above the cut-off point had the largest hazard ratio to predict poor outcome in VSA patients [hazard ratio (95% confidence interval) 11.19 (1.41-88.95); P = 0.022]. Importantly, combination of the Japanese Coronary Spasm Association risk score and Rho-kinase activity significantly improved the prognostic impact in VSA patients as compared with either alone. Conclusion Rho-kinase activity in circulating leucocytes is useful for prognostic stratification of VSA patients.

Original languageEnglish
Pages (from-to)952-959
Number of pages8
JournalEuropean Heart Journal
Issue number11
Publication statusPublished - 2018 Mar 14


  • Biomarkers
  • Prognosis
  • Rho-kinase
  • Risk factors
  • Vasospastic angina

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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