Blood acetylcholinesterase activity is associated with increased 10 year all-cause mortality following coronary angiography

Abstract Background and aims Parasympathetic dysfunction is associated with increased risk for major adverse cardiovascular events (MACE). However, clinically validated biomarkers that reflect parasympathetic activity are not yet available. We sought to assess the ability of serum cholinesterase activity to predict long term survival in patients undergoing coronary angiography. Methods We prospectively followed 1002 consecutive patients undergoing clinically indicated coronary angiography (acute coronary syndrome or stable angina). We measured blood acetylcholinesterase (AChE) activity using the acetylcholine analog acetylthiocholine. Mortality rates were determined up to 10 years of follow-up. We divided our cohort into 3 groups with low, intermediate and high AChE activity by a Chi-square automatic interaction detection method (CHAID). Results Patients with lower than cutoff levels of AChE ( Conclusions Patients presenting for coronary angiography with low levels of serum AChE activity are at increased risk for death during long term follow-up.