Plasma Ceramides.
Level 3 - non-randomized controlled study
Prospective observational cohort study with multivariable adjustment
PubMed 29903731 · doi:10.1161/ATVBAHA.118.311199
What was done
Plasma concentrations of four ceramides—Cer(16:0), Cer(18:0), Cer(24:1), and Cer(24:0)—were measured in 495 patients prior to nonurgent coronary angiography. Baseline coronary artery disease (CAD, defined as >50% stenosis in ≥1 coronary artery) was assessed, and participants were followed for up to 4 years for a composite primary endpoint of myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, stroke, or death. Multivariable Cox models adjusted for age, sex, body mass index, hypertension, smoking, LDL cholesterol, HDL cholesterol, triglycerides, serum glucose, and family history of CAD.
What was found
Baseline CAD was identified in 265 participants (54%), but ceramide concentrations were not significantly associated with the presence of CAD. Over 4 years of follow-up, elevated ceramides significantly predicted the composite adverse cardiovascular outcome after multivariable adjustment. The fully adjusted hazard ratios per standard deviation (95% CI) were 1.50 (1.16–1.93) for Cer(16:0), 1.42 (1.11–1.83) for Cer(18:0), 1.43 (1.08–1.89) for Cer(24:1), and 1.58 (1.22–2.04) for the composite ceramide risk score. Specific numerical results for Cer(24:0) were not reported in the abstract.
Why it matters
This study reinforces the utility of circulating ceramides as prognostic biomarkers for major adverse cardiovascular events independent of traditional lipid markers and existing CAD status.
Limits
The study was conducted in a single referred population undergoing elective angiography, which limits generalizability to primary prevention or lower-risk cohorts. The composite endpoint grouped heterogeneous events (revascularization alongside hard clinical outcomes like stroke and death), and the abstract lacks individual event counts and specific numeric risk estimates for Cer(24:0).
Cited by
- supports The Mayo Clinic has a clinical ceramide score that predicts cardiovascular disease prognosis.