N-terminal and C-terminal fragments of IGFBP-4 as novel biomarkers for short-term risk assessment of major adverse cardiac events in patients presenting with ischemia.

Abstract:

OBJECTIVES:Pregnancy Associated Plasma Protein A (PAPP-A)-derived N- and C-terminal fragments of IGF-binding protein-4 (NT- and CT-IGFBP-4) released from vulnerable atherosclerotic plaques are proposed to be used for cardiovascular risk assessment. DESIGN AND METHODS:NT- and CT-IGFBP-4 were measured by novel immunoassays in EDTA-plasma of 180 patients admitted to the emergency department with symptoms of myocardial ischemia but without ST-segment elevation. Six-month incidence of major adverse cardiac events (MACE), including myocardial infarction, cardiac death, percutaneous coronary interventions, and coronary artery bypass grafting was recorded. RESULTS:Sixteen patients met the endpoint. NT- and CT-IGFBP-4 were strong predictors of MACE: area under ROC curve (AUC) 0.856 and 0.809, respectively. NT-IGFBP-4 concentrations≥214μg/L and CT-IGFBP-4 concentrations≥124μg/L were associated with increased risk of future MACE: adjusted hazard ratio 13.79 and 7.93, respectively. CONCLUSIONS:IGFBP-4 fragments can be utilized as biomarkers for MACE prediction in patients with suspected myocardial ischemia.

journal_name

Clin Biochem

journal_title

Clinical biochemistry

authors

Postnikov AB,Smolyanova TI,Kharitonov AV,Serebryanaya DV,Kozlovsky SV,Tryshina YA,Malanicev RV,Arutyunov AG,Murakami MM,Apple FS,Katrukha AG

doi

10.1016/j.clinbiochem.2011.12.030

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

519-24

issue

7-8

eissn

0009-9120

issn

1873-2933

pii

S0009-9120(12)00043-4

journal_volume

45

pub_type

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