Does Podoplanin (PDPN) Reflect the Involvement of the Immunological System in Coronary Artery Disease Risk? A Single-Center Prospective Analysis

Abstract

Coronary artery disease remains a significant global health challenge, driven by a multifactorial pathophysiology, including immunological activation. The identification and management of potential risk factors are crucial for improving prevention opportunities. In this study, the role of novel, innate immune system response markers, such as podoplanin 38, in atherosclerosis was investigated. A total of 150 consecutive patients (87 (58%) male; median age of 68 (61–76) years) with chronic coronary symptoms (anginal equivalent, e.g., exertional dyspnea) who underwent clinical evaluation and de novo coronary angiography for a prospective single-center analysis were included. Demographic and clinical data, combined with echocardiographic and coronary angiography results, were analyzed in conjunction with laboratory results from admission, including serum podoplanin (PDPN) concentrations. Serum PDPN concentrations were significantly lower in the coronary artery disease group (238 (174–360) pg/mL) compared to the control group (428 (207–1381) pg/mL, p = 0.002). A negative correlation was observed between PDPN and the number of involved coronary arteries in the atherosclerotic process (R = −0.27, p < 0.01). In diabetic populations, glycemic hemoglobin (Hb1Ac) is correlated with the podoplanin concentration (r = −0.51, p = 0.001). A correlation between PDPN and the left ventricular ejection fraction was noted in both the control (r = 0.33, p < 0.01) and CAD groups (r = 0.37, p < 0.001). Podoplanin (PDPN) can be considered a novel marker for coronary atherosclerosis. Low serum podoplanin concentrations characterized patients with coronary artery disease.