The second life of the ambiguous angiotensin-converting enzyme 2 as a predictive biomarker for cardiometabolic diseases and death

This nested case-cohort analysis from the multinational Prospective Urban Rural Epidemiology (PURE) study analyzed plasma levels of a component of the renin-angiotensin system (RAS), angiotensin-converting enzyme 2 (ACE2), as a predictor of cardiovascular (CV) events [CV mortality, myocardial infarction (MI), stroke, heart failure (HF)] and all-cause mortality. • From a total population of 55 246 PURE participants from 14 countries across five continents, the authors took a random sample (the subcohort). The final sample consisted of participants who were members of the subcohort (n ¼ 5084) and those who had incident events outside the subcohort (n ¼ 5669). The median follow-up was 9.4 years (IQR, 8.7–10.5).