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Circulating fatty-acid binding-protein 4 levels predict CV events in patients after coronary interventions
Hao-Yuan Tsai1, Yen-Wen Wu2, Wei-Kung Tseng3
1Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Insights
Fatty-acid binding protein-4 (FABP4) predicts composite cardiovascular events in patients with coronary heart disease (CHD) after interventions. Higher FABP4 levels indicate an increased risk for adverse outcomes, highlighting its prognostic value.
Area of Science:
- Cardiology
- Biomarkers
- Metabolic Syndrome
Background:
- Fatty-acid binding protein-4 (FABP4) is linked to metabolic syndrome, diabetes, atherosclerosis, and heart failure.
- Previous studies yielded conflicting results on FABP4's association with cardiovascular mortality in high-risk patients or those with coronary heart disease (CHD).
Purpose of the Study:
- To investigate the prognostic significance of FABP4 in patients with established CHD undergoing coronary interventions.
- To determine if FABP4 levels predict major adverse cardiovascular events post-intervention.
Main Methods:
- Serum FABP4 levels were measured in 973 patients post-successful CHD intervention.
- Patients were prospectively followed for 30 months to record composite cardiovascular outcomes.
Main Results:
- A composite outcome occurred in 22.92% of patients during follow-up.
- Elevated baseline FABP4 levels (highest tertile) were significantly associated with increased risk of composite cardiovascular outcomes (HR 1.662, p=0.0022).
- This association remained significant after multivariate adjustments for traditional risk factors and hs-CRP (HR 1.596, p=0.0168).
Conclusions:
- Circulating FABP4 serves as an independent prognostic marker for composite cardiovascular events in patients with stable CHD after coronary interventions.
- FABP4 may aid in risk stratification for patients with CHD post-intervention.
Background:
Fatty-acid binding protein-4 (FABP4) has been associated with the metabolic syndrome, diabetes mellitus, atherosclerosis, incident heart failure, and the prognosis of coronary heart disease (CHD). However, recent studies have not reported a significant correlation between FABP4 and cardiovascular (CV) mortality in high-risk patients or those with documented CHD. The present study aimed to evaluate the association between FABP4 and the prognosis in a cohort of patients with CHD who received coronary interventions.
Methods:
Serum FABP4 levels were measured in 973 patients after a successful intervention for CHD, who were then prospectively followed for 30 months.
Result:
During this period, 223 patients experienced composite CV outcomes (22.92%), defined as cardiovascular/cerebrovascular death, nonfatal myocardial infarction (MI), nonfatal stroke, hospitalization for refractory or unstable angina, hospitalization for heart failure, and peripheral artery occlusive disease. Kaplan-Meier curves showed a significant association between FABP4 levels at baseline (categorized in tertiles) and composite CV outcomes during follow-up (log-rank test, p < 0.003). The patients with the highest tertile of baseline FABP4 had an increased risk of composite CV outcomes (hazard ratio (HR) 1.662; 95% confidence interval (CI), 1.2-2.302; p = 0.0022), which remained significant after multivariate adjustments for traditional risk factors and hs-CRP (HR 1.596; 95% CI, 1.088-2.342; p = 0.0168). In contrast, FABP4 failed to show a significant association with cardiovascular/cerebrovascular death, nonfatal MI, or nonfatal stroke after multivariate adjustments (HR, 1.594; 95% CI, 0.651-3.904, p = 0.3073).
Conclusion:
In conclusion, circulating FABP4 is an independent prognostic predictor for the composite cardiovascular events in the patients with stable CHD after coronary interventions.
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