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.

• Authors: A B Postnikov, T I Smolyanova, A V Kharitonov, D V Serebryanaya, S V Kozlovsky, Y A Tryshina, R V Malanicev, A G Arutyunov, M M Murakami, F S Apple, A G Katrukha
• Journal: Clinical biochemistry (Clin Biochem) Vol. 45 Issue 7-8 Pg. 519-24 (May 2012) ISSN: 1873-2933 [Electronic] United States
• PMID: 22306170 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Insulin-Like Growth Factor Binding Protein 4
• Peptide Fragments
• Pregnancy-Associated Plasma Protein-A

Topics

• Aged
• Aged, 80 and over
• Amino Acid Sequence
• Animals
• Area Under Curve
• Biomarkers (blood)
• Coronary Artery Bypass
• Cross Reactions
• Female
• HEK293 Cells
• Humans
• Immunoassay
• Insulin-Like Growth Factor Binding Protein 4 (blood)
• Male
• Mice
• Mice, Inbred BALB C
• Middle Aged
• Molecular Sequence Data
• Myocardial Ischemia (diagnosis, pathology)
• Peptide Fragments (blood)
• Plaque, Atherosclerotic (metabolism)
• Pregnancy-Associated Plasma Protein-A (analysis)
• Proportional Hazards Models
• Prospective Studies
• Proteolysis
• ROC Curve
• Risk Assessment
• Risk Factors
• Sensitivity and Specificity
• Time Factors