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Association of Circulating Brain-Derived Neurotrophic Factor With Coronary Risk Factors and Coronary Artery Disease
Tetsuro Tachibana1, Yuhei Shiga1, Erika Miura-Takahashi1
1Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
Insights
Low plasma brain-derived neurotrophic factor (BDNF) in coronary artery disease (CAD) patients is linked to platelet count, not the disease itself. Platelet levels confound BDNF as a biomarker for cardiovascular risk in intermediate-risk patients.
Area of Science:
- Cardiovascular Research
- Neuroscience
- Biomarker Discovery
Background:
- Previous studies show inconsistent findings on low circulating brain-derived neurotrophic factor (BDNF) in coronary artery disease (CAD).
- Platelet-related factors may influence reported BDNF concentrations in CAD patients.
- This study investigates the association between plasma BDNF and CAD using coronary computed tomography angiography (CCTA).
Purpose of the Study:
- To evaluate the association between plasma BDNF levels and the presence of CAD.
- To determine the influence of platelet count on the relationship between plasma BDNF and CAD.
- To assess BDNF's potential as a reliable biomarker for CAD in patients undergoing CCTA.
Main Methods:
- Prospective enrollment of 402 patients undergoing CCTA for CAD screening or risk assessment.
- CAD defined as coronary artery stenosis ≥50%.
- Plasma BDNF levels measured and analyzed for association with CAD using multivariate regression, adjusting for clinical variables and platelet count.
Main Results:
- Patients with CAD (n=186) exhibited lower plasma BDNF levels than those without CAD (n=216).
- Platelet count was identified as the strongest determinant of plasma BDNF levels (β = 0.027, P < 0.001).
- The initial association between higher BDNF and lower CAD prevalence became non-significant after adjusting for platelet count.
Conclusions:
- Lower plasma BDNF in CAD patients is largely explained by platelet count, not CAD itself.
- Platelet count is a critical confounding factor when assessing BDNF as a cardiovascular biomarker.
- Consider platelet levels when evaluating BDNF in patients with intermediate cardiovascular risk.
Background:
Previous studies have reported low circulating brain-derived neurotrophic factor (BDNF) concentrations in patients with coronary artery disease (CAD), but findings have been inconsistent and may be influenced by platelet-related factors. This study evaluated the association between plasma BDNF and CAD in patients undergoing coronary computed tomography angiography (CCTA).
Methods:
We prospectively enrolled 402 consecutive patients who underwent CCTA for CAD screening at Fukuoka University Hospital and who were either clinically suspected of having CAD or had at least one cardiovascular risk factor. CAD was defined as coronary artery stenosis of 50% or greater. Plasma BDNF was measured and its association with CAD and clinical variables was examined using multivariate linear regression and logistic regression. The effect of covariate adjustment on the association between BDNF and CAD was assessed using the change-in-estimate method.
Results:
Patients with CAD (n = 186) had lower plasma BDNF levels compared with patients without CAD (n = 216) (5.73 ± 3.16 vs. 6.41 ± 3.42 ng/mL, P = 0.039). Multivariate linear regression analysis revealed that platelet count was the strongest determinant of plasma BDNF levels (β = 0.027, P < 0.001). Unadjusted logistic regression analysis showed that higher BDNF levels were associated with a lower prevalence of CAD (odds ratio (OR) 0.94, 95% confidence interval (CI) 0.88-1.00, P = 0.039). However, after adjusting for platelet count, this association weakened and became non-significant (OR 0.976, 95% CI 0.909-1.05, P = 0.49). Further adjustment for age and coronary artery calcification score did not significantly alter the results.
Conclusions:
In a cohort undergoing CCTA with a relatively intermediate pre-test probability of CAD, plasma BDNF levels were lower in patients with CAD, but this crude correlation was primarily explained by platelet-related confounding factors. Platelet count should be considered when evaluating BDNF as a cardiovascular biomarker in patients with intermediate cardiovascular risks.
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