Circulating fatty-acid binding-protein 4 levels predict CV events in patients after coronary interventions

Abstract

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. Serum FABP4 levels were measured in 973 patients after a successful intervention for CHD, who were then prospectively followed for 30 months. 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). In conclusion, circulating FABP4 is an independent prognostic predictor for the composite cardiovascular events in the patients with stable CHD after coronary interventions.