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The following is a summary of “RBP4-based Multimarker Score: A Prognostic Tool for Adverse Cardiovascular Events in Acute Coronary Syndrome Patients,” published in the December 2023 issue of Endocrinology by Ye, et al.

Retinol-binding protein 4 (RBP4) has been suggested as a potential contributor to cardiovascular diseases. Yet, its connection with major adverse cardiovascular events (MACEs) in patients diagnosed with acute coronary syndrome (ACS) needs to be better defined. For a study, researchers sought to investigate the prognostic significance of baseline RBP4 levels and a composite multimarker score derived using specific criteria in predicting MACEs in individuals with ACS.

A cohort of 826 ACS patients was systematically recruited from the cardiology department. These patients were then followed up for a median duration of 1.95 years, with the interquartile range spanning from 1.02 to 3.25 years. The concentration of plasma RBP4 was measured using the enzyme-linked immunosorbent assay method. The study focused on the adjusted associations between RBP4 concentrations and its derived multimarker score. Specifically, the multimarker score criteria involved assigning 1 point when RBP4 was ≥ 38.18μg/mL, left ventricular ejection fraction (LVEF) was ≤ 55%, N-terminal pro-B-type natriuretic peptide (NT-proBNP) was ≥ 450 ng/L, estimated glomerular filtration rate (eGFR) was ≤ 90 mL/min/1.73 m², and the patient’s age was ≥ 60 years.

Out of the entire cohort, 269 ACS patients (32.57%) experienced MACEs. When categorizing patients based on the multimarker score, with ranges of 0-1 (n = 315), 2-3 (n = 406), and 4-5 (n = 105), a significant graded association with the risk of MACEs was observed. Specifically, for those falling within the 2-3 range, the adjusted hazard ratio (HR_adj) was 1.80 (95% CI, 1.34-2.41), and for those in the 4-5 range, the HR_adj was 3.26 (95% CI, 2.21-4.81). This relationship was consistent across the components of MACEs (P < .05 for each). Importantly, even among ACS patients with various high-risk anatomical or clinical characteristics, the prognostic and discriminatory value of the RBP4-derived multimarker score remained robust.

The 5-item score derived from RBP4 offers a valuable tool for risk stratification and serves as a guide for secondary prevention strategies in patients diagnosed with ACS.

Source: academic.oup.com/jcem/article-abstract/108/12/3111/7218759?redirectedFrom=fulltext