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Retinol-binding Protein 4 as a Predictor of Cardiovascular Events after Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction
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DOI：10.5551/jat.65886.png)
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Abstract
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Aim: This study explored the association between retinol-binding protein 4 (RBP4) and cardiovascular events in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods: A total of 736 AMI patients who underwent successful PCI were prospectively enrolled between January 2020 and January 2022. The baseline RBP4 levels were measured by ELISA and categorized into quartiles. The incidence of major adverse cardiovascular events (MACEs), including all-cause mortality, recurrent myocardial infarction, revascularization, heart failure, and stroke, was assessed at the 1- and 3-year follow-up. Multivariate Cox proportional hazards models were used to evaluate the association between RBP4 and MACEs. A receiver operating characteristic (ROC) curve analysis was performed to determine the predictive efficiency of RBP4 for predicting the 1-year and 3-year MACEs. Results: During follow-up, 110 (14.95%) and 165 (22.42%) patients developed MACEs at one and three years, respectively. Elevated RBP4 (the fourth quartile vs. the first quartile) was associated with an increased risk of MACEs (HR = 2.18, 95%CI = 1.42-4.37, P = 0.007) and heart failure (HR = 3.89, 95%CI = 1.68-5.75, P< 0.001) at the 1-year follow-up. Additionally, the elevated RBP4 were associated with an increased risk of MACEs (HR = 4.41, 95%CI = 2.57-7.31, P<0.001), revascularization (HR = 3.43, 95%CI = 1.82-4.87, P<0.001) and heart failure (HR = 7.12, 95%CI = 3.78-11.92, P<0.001) at 3-year follow-ups. An ROC curve analysis revealed that the serum RBP4 cutoff for predicting the 1-year MACEs was 46.3 ng/mL (AUC = 0.74, 95%CI = 0.69-0.78, P<0.001), and for predicting the 3-year MACEs, it was 43.9 ng/mL (AUC = 0.81, 95%CI = 0.77-0.85, P<0.001). A Stratified Cox regression analysis suggested that the renal function did not significantly modify the association between RBP4 and MACEs. Conclusion: Elevated RBP4 levels are independently associated with an increased risk of MACEs in patients with AMI post-PCI, thus highlighting its potential as a prognostic biomarker for risk stratification.
Keywords:
Retinol-binding protein 4
Acute myocardial infarction
Percutaneous coronary intervention
Cardiovascular events
Risk factors
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