RBP4-based Multimarker Score: A Prognostic Tool for Adverse Cardiovascular Events in Acute Coronary Syndrome Patients

内科学 医学 急性冠脉综合征 四分位间距 心脏病学 射血分数 肾功能 维加维斯 利钠肽 心力衰竭 胰岛素抵抗 心肌梗塞 肥胖 脂肪因子
作者
Bingqi Ye,Qian Zhao,Jiahua Fan,Xiaomei Li,Chunfang Shan,Fen Liu,Ning Song,Jiajun Zhu,Min Xia,Yan Liu,Yi‐Ning Yang
出处
期刊:The Journal of Clinical Endocrinology and Metabolism [Oxford University Press]
卷期号:108 (12): 3111-3121
标识
DOI:10.1210/clinem/dgad389
摘要

Retinol binding protein 4 (RBP4) has been implicated in the progression of cardiovascular diseases. However, its association with major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) remains obscure.Here, we examined the prognostic value of baseline RBP4 and its derived multimarker score for MACEs in ACS patients.A total of 826 patients with ACS were consecutively recruited from the department of cardiology and prospectively followed up for a median of 1.95 years (interquartile range, 1.02-3.25 years). Plasma RBP4 was measured using enzyme-linked immunosorbent assay. Adjusted associations between RBP4 and its derived multimarker score (1 point was assigned when RBP4 ≥ 38.18μg/mL, left ventricular ejection fraction [LVEF] ≤ 55%, N-terminal pro-B-type natriuretic peptide [NT-proBNP] ≥ 450 ng/L, estimated glomerular filtration rate [eGFR] ≤ 90 mL/min/1.73 m2, and age ≥60) with MACEs were analyzed.In total, 269 ACS patients (32.57%) experienced MACEs. When patients were grouped by multimarker score (0-1, n = 315; 2-3, n = 406; 4-5, n = 105), there was a significant graded association between RBP4-based multimarker score and risk of MACEs (intermediate score (2-3): HRadj: 1.80; 95% CI, 1.34-2.41; high score (4-5): HRadj: 3.26; 95% CI, 2.21-4.81) and its components (P < .05 for each). Moreover, the prognostic and discriminative value of the RBP4-derived multimarker score remained robust in ACS patients with various high-risk anatomical or clinical characteristics.The RBP4-derived 5-item score serves as a useful risk stratification and decision support for secondary prevention in patients with ACS.
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