The value of plasma fibrillin-1 level in patients with spontaneous coronary artery dissection. (1st March 2020)

• Record Type: Journal Article
• Authors: Hui, Peng; Bai, Yang; Su, Xing; Quan, Nanhu; Qiao, Bokang; Zheng, Yang; Shi, Jiangcheng; Du, Xiaoyu; Lu, Jie
• Is Part Of: International journal of cardiology. Volume 302(2020)
• Page Start: 150
• Page End: 156
• Publication Date: 2020-03-01
• Subjects: Spontaneous coronary artery dissection -- Fibrillin-1 -- Biomarker; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2019.12.015
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Spontaneous coronary artery dissection (SCAD) has emerged as an important etiology of myocardial infarction and sudden death, especially in young women. Early diagnosis is essential for appropriate management. Objectives: To explore the value of plasma fibrillin-1 (FBN1) levels in patients with SCAD. Methods: 70 patients with non-atherosclerotic SCAD between January 2014 and September 2018 were age and sex matched with 70 patients with non-SCAD acute coronary syndrome (ACS) and 70 healthy controls. The plasma FBN1 level was measured and compared among three groups. The value of FBN1 for prognosis and treatment decision making was further explored. Results: The plasma FBN1 level of SCAD group (58.44 ± 7.06 ng/mL) was higher than that of non-SCAD ACS group (52.39 ± 6.92 ng/mL, P < 0.001) or healthy controls (50.56 ± 4.48 ng/mL, P < 0.001). Compared with controls, significantly higher percentages of patients with SCAD were found in the highest compared with lowest quartile of FBN1 concentration. The area under the curve (AUC) for plasma FBN1 level to discriminate patients with SCAD from non-SCAD ACS was 0.81 (95% CI 0.74–0.88, P < 0.001). A cut-off value of 54.64 ng/mL was determined to differentiate SCAD from non-SCAD ACS with a sensitivity of 0.77 (95%CI: 0.66–0.86) and specificity of 0.76 (95%CI: 0.64–0.85). After a median follow-up of 28.35 (14.07 ± 44.69) months, 11 (15.7%) cases suffered from major adverse cardiac events (MACE). Higher FBN1 level was detected in patients with MACE (63.71 ± 7.49 vs. 57.45 ± 6.58 ng/mL) ( P = 0.006). A cut-point of 58.14 was determined for SCAD patients to identify MACE. At this point, FBN1 might also have potential use for decision making in SCAD patients. Conclusion: Plasma FBN1 is a promising biomarker for aiding the diagnosis of SCAD and have potential value in prognosis prediction. Highlights: Plasma fibrillin-1 (FBN1) rises in spontaneous coronary artery dissection (SCAD) patients. FBN1 may be an effective diagnostic biomarker for SCAD patients. Elevated plasma FBN1 levels are associated with a poor prognosis in SCAD patients. Plasma FBN1 might have potential use to guide decision making in SCAD patients.