Protein Z levels and prognosis in patients with acute coronary syndromes

Francesco Sofi, Francesca Cesari, Rossella Marcucci, Cinzia Fatini, Anna Maria Gori, Cristina Giglioli, Serafina Valente, Sandra Fedi, Rosanna Abbate, Gian Franco Gensini

Research output: Contribution to journalArticlepeer-review


Background: Protein Z, a vitamin K-dependent glycoprotein, serves as a cofactor for the inhibition of activated coagulation factor X. During recent years, a role for low levels of protein Z in prothrombotic disorders such as ischemic stroke and acute coronary syndromes (ACS) has been reported. The aims of this study were to test changes in protein Z and their association with outcome at 1-year follow-up in 193 (150 male, 43 female) patients with ACS. Results: Protein Z plasma levels were significantly lower (p <0.0001) after 1 year [1600 (28-3736) ng/mL] compared to the baseline [1695 (294-4068) ng/mL]. Regression analysis showed a significant association between baseline protein Z below the 5th percentile of our control group and subsequent adverse cardiac events at follow-up (odds ratio 3.3; 95% CI 1.04-10.7; P = 0.04). Moreover, Cox regression analysis showed that low protein Z levels at admission were significant predictors of major adverse cardiac events (cardiac death, non-fatal recurrent myocardial infarction, and need for target lesion revascularization) after 1 year (hazard risk 2.5; 95% CI 1.02-6.5, p = 0.04). Conclusions: Our results show that in patients with ACS: 1) protein Z decreases moving from the acute to the convalescent phase; and 2) low levels of baseline protein Z are significantly associated with adverse outcome at 1-year follow-up.

Original languageEnglish
Pages (from-to)1098-1102
Number of pages5
JournalClinical Chemistry and Laboratory Medicine
Issue number9
Publication statusPublished - Sep 1 2006


  • Acute coronary syndromes
  • Major adverse cardiac events
  • Prognosis
  • Protein Z

ASJC Scopus subject areas

  • Clinical Biochemistry


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