Relationship between serum thymosin β4 levels and coronary collateral development.

BACKGROUND: Thymosin β4 was recently demonstrated to be a potential stimulator of angiogenesis and arteriogenesis in both in-vivo and in-vitro studies. Little is known about the relationship between serum thymosin β4 levels and the extent of coronary collaterals in patients with coronary artery disease.

HYPOTHESIS: Serum thymosin β4 independently predicts the formation of coronary collaterals in patients with coronary artery disease.

MATERIALS AND METHODS: A total of 190 consecutive patients who underwent coronary angiography were divided into two groups according to coronary angiograms and collateral formation: the poor collateral group consisting of 103 patients with at least more than or equal to one coronary stenosis of greater than or equal to 75% without visible collateral circulation, and the good collateral group consisting of 87 patients with at least more than or equal to one coronary stenosis of greater than or equal to 75% with well-developed collateral circulation. Collateral score was analyzed using the Cohen-Rentrop classification.

RESULTS: Serum thymosin β4 levels were 1024.50 ± 516.92 ng/ml and 1373.00 ± 1082.88 ng/ml for patients in the poor collateral group and the good collateral group, respectively. Serum thymosin β4 levels in the good collateral group were significantly higher than those in the poor collateral group (P<0.01). After adjustment in the multiple ordinal logistic regression model, serum thymosin β4 levels showed a strong independent association with the collateral Cohen-Rentrop score (χ(2)=4.45, odds ratio=1.00, 95% confidence interval: 1.000-1.002, P=0.035).

CONCLUSION: Elevated serum thymosin β4 level is independently associated with a significant enhancement in coronary collateralization and patients in the good collateral tend to have a higher thymosin β4 level.