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The value of plasma fibrillin-1 level in patients with spontaneous coronary artery dissection
Peng Hui1, Yang Bai2, Xing Su3
1Department of Ophthalmology, the First Hospital of Jilin University, China.
Insights
Plasma fibrillin-1 (FBN1) levels are elevated in patients with spontaneous coronary artery dissection (SCAD), aiding diagnosis. Higher FBN1 levels also predict major adverse cardiac events in SCAD patients.
Area of Science:
- Cardiology
- Biomarker Discovery
- Vascular Biology
Background:
- Spontaneous coronary artery dissection (SCAD) is a significant cause of myocardial infarction, particularly in young women.
- Accurate and early diagnosis of SCAD is critical for effective patient management.
- Identifying reliable biomarkers for SCAD is an ongoing area of research.
Purpose of the Study:
- To investigate the diagnostic and prognostic value of plasma fibrillin-1 (FBN1) levels in patients with SCAD.
- To compare FBN1 levels between SCAD patients, non-SCAD acute coronary syndrome (ACS) patients, and healthy controls.
- To explore the potential of FBN1 as a biomarker for predicting adverse cardiac events in SCAD.
Main Methods:
- A case-control study involving 70 SCAD patients, 70 non-SCAD ACS patients, and 70 healthy controls.
- Plasma FBN1 levels were measured and compared across the three groups.
- Follow-up assessments were conducted to evaluate major adverse cardiac events (MACE) and their correlation with FBN1 levels.
Main Results:
- Plasma FBN1 levels were significantly higher in the SCAD group compared to both non-SCAD ACS patients and healthy controls (P < 0.001).
- A plasma FBN1 cut-off value of 54.64 ng/mL demonstrated good discriminatory ability (AUC = 0.81) for identifying SCAD.
- Elevated FBN1 levels were associated with an increased risk of MACE in SCAD patients during follow-up (P = 0.006).
Conclusions:
- Plasma FBN1 is a promising biomarker that can assist in the diagnosis of spontaneous coronary artery dissection.
- FBN1 levels hold potential value in predicting the prognosis of SCAD patients, including the risk of major adverse cardiac events.
- Further research may establish FBN1 as a valuable tool for clinical decision-making in SCAD management.
Background:
Spontaneous coronary artery dissection (SCAD) has emerged as an important etiology of myocardial infarction and sudden death, especially in young women. Early diagnosis is essential for appropriate management.
Objectives:
To explore the value of plasma fibrillin-1 (FBN1) levels in patients with SCAD.
Methods:
70 patients with non-atherosclerotic SCAD between January 2014 and September 2018 were age and sex matched with 70 patients with non-SCAD acute coronary syndrome (ACS) and 70 healthy controls. The plasma FBN1 level was measured and compared among three groups. The value of FBN1 for prognosis and treatment decision making was further explored.
Results:
The plasma FBN1 level of SCAD group (58.44 ± 7.06 ng/mL) was higher than that of non-SCAD ACS group (52.39 ± 6.92 ng/mL, P < 0.001) or healthy controls (50.56 ± 4.48 ng/mL, P < 0.001). Compared with controls, significantly higher percentages of patients with SCAD were found in the highest compared with lowest quartile of FBN1 concentration. The area under the curve (AUC) for plasma FBN1 level to discriminate patients with SCAD from non-SCAD ACS was 0.81 (95% CI 0.74-0.88, P < 0.001). A cut-off value of 54.64 ng/mL was determined to differentiate SCAD from non-SCAD ACS with a sensitivity of 0.77 (95%CI: 0.66-0.86) and specificity of 0.76 (95%CI: 0.64-0.85). After a median follow-up of 28.35 (14.07 ± 44.69) months, 11 (15.7%) cases suffered from major adverse cardiac events (MACE). Higher FBN1 level was detected in patients with MACE (63.71 ± 7.49 vs. 57.45 ± 6.58 ng/mL) (P = 0.006). A cut-point of 58.14 was determined for SCAD patients to identify MACE. At this point, FBN1 might also have potential use for decision making in SCAD patients.
Conclusion:
Plasma FBN1 is a promising biomarker for aiding the diagnosis of SCAD and have potential value in prognosis prediction.
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