Circulating surfactant protein-D and the risk of cardiovascular morbidity and mortality

John Hill, Claire Heslop, S. F.Paul Man, Jiri Frohlich, John E. Connett, Nick R. Anthonisen, Robert A. Wise, Donald P. Tashkin, Don D. Sin

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Aims Surfactant protein-D (SP-D) is a lung-specific protein that is detectable in human plasma. We determined the relationship of circulating SP-D to cardiovascular disease (CVD) and total mortality in subjects with and without CVD. Methods and resultsPlasma SP-D levels were measured in 806 patients who underwent coronary angiography to assess its predictive value for cardiovascular mortality. Serum SP-D levels were also measured in a replication cohort to assess its relationship with CVD events in 4468 ex-and current smokers without a known history of coronary artery disease (CAD). Patients who died during follow-up had significantly higher plasma SP-D levels than those who survived (median 85.4 vs. 64.8 ng/mL; P < 0.0001). Those in the highest quintile of SP-D had 4.4-fold higher risk of CVD mortality than those in the lowest quintile (P < 0.0001) independent of age, sex, and plasma lipid levels. In a group of current and ex-smokers without a known history of CAD, serum SP-D levels were elevated in those who died or were hospitalized for CVD compared with those who did not (median 99.8 vs. 90.6 ng/mL; P 0.0001). Conclusion Circulating SP-D is a good predictor of cardiovascular morbidity and mortality and adds prognostic information to well-established risk factors such as age, sex, and plasma lipids and is a promising biomarker to link lung inflammation/injury to CVD.

Original languageEnglish (US)
Pages (from-to)1918-1925
Number of pages8
JournalEuropean heart journal
Issue number15
StatePublished - Aug 2011


  • Biomarkers
  • Cardiovascular mortality
  • Heart disease
  • Lung inflammation
  • Surfactant

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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