Peroxiredoxin 4, a novel circulating biomarker for oxidative stress and the risk of incident cardiovascular disease and all-cause mortality

Ali Abbasi*, Eva Corpeleijn, Douwe Postmus, Ronald Gansevoort, Paul E. de Jong, Reinold Gans, Joachim Struck, Janin Schulte, Hans L. Hillege, Pim van der Harst, Linda M. Peelen, Joline W. J. Beulens, Ronald P. Stolk, Gerarda Navis, Stephanus Bakker

*Corresponding author for this work

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Background-Oxidative stress has been suggested to play a key role in the development of cardiovascular disease (CVD). The aim of our study was to investigate the associations of serum peroxiredoxin 4 (Prx4), a hydrogen peroxide-degrading peroxidase, with incident CVD and all-cause mortality. We subsequently examined the incremental value of Prx4 for the risk prediction of CVD compared with the Framingham risk score (FRS).

Methods and Results-We performed Cox regression analyses in 8141 participants without history of CVD (aged 28 to 75 years; women 52.6%) from the Prevention of Renal and Vascular End-stage Disease (PREVEND) study in Groningen, The Netherlands. Serum Prx4 was measured by an immunoluminometric assay in baseline samples. Main outcomes were: (1) incident CVD events or CVD mortality and (2) all-cause mortality during a median follow-up of 10.5 years. In total, 708 participants (7.8%) developed CVD events or CVD mortality, and 517 participants (6.3%) died. Baseline serum Prx4 levels were significantly higher in participants with incident CVD events or CVD mortality and in those who died than in participants who remained free of outcomes (both P

Conclusions-Elevated serum Prx4 levels are associated with a significantly higher risk of incident CVD events or CVD mortality and all-cause mortality after adjustment for clinical risk factors. The addition of Prx4 to the FRS marginally improved risk prediction of future CVD.

Original languageEnglish
Article numbere002956
Number of pages12
JournalJournal of the American Heart Association
Issue number5
Publication statusPublished - Oct-2012


  • cardiovascular disease
  • epidemiology
  • mortality
  • oxidative stress
  • peroxiredoxin 4
  • IV

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