Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.
Eur J Med Res. 2023 Jan 18;28(1):32. doi: 10.1186/s40001-023-01002-z.
Microfibrillar-associated protein (MFAP4), initially identified as an extracellular matrix protein, has been demonstrated in multiple human disorders, but it is yet to be discovered following acute coronary syndrome (ACS) in clinical practice. Therefore, this study aimed to investigate the relationship between circulating MFAP4 levels and coronary stenosis in ACS.
We performed the study in 148 ACS subjects, including 75 ST-segment elevation myocardial infarction (STEMI), 27 non-ST-segment elevation myocardial infarction (non-STEMI) and 46 unstable angina (UA). Clinical variables were collected and Gensini and Syntax stenosis scoring systems were applied to assess the severity of coronary stenosis. Kaplan-Meier and logistic regression analysis were used to analyze the relationship between MFAP4 and the severity of coronary stenosis or ACS outcomes. Spearman analysis was used to describe the correlation between MFAP4 and clinical parameters.
Circulating MFAP4 levels were significantly decreased in the STEMI group (0.008 ng/ml) compared with the non-STEMI group (0.014 ng/ml) and UA group (0.019 ng/ml) (p < 0.001). After adjusting for confounding factors, we found that MFAP4 was an independent risk factor for STEMI (odds ratio = 0.395, 95% CI 0.174-0.895, p = 0.026). MFAP4 level was negatively correlated with Gensini score and Syntax score (r = - 0.311 and - 0.211, p < 0.001 and 0.01, respectively). Based on the MFAP4 level of 0.117 ng/ml, ACS patients were divided into two groups: the low-MFAP4 group (< 0.117 ng/ml, n = 60) and the high-MFAP4 group (≥ 0.117 ng/ml, n = 88). After the median follow-up of 165 days, Kaplan-Meier survival analysis revealed that the MACE-free rate was significantly lower in ACS patients with lower MFAP4 levels (p = 0.009).
MFAP4 has a potential as a biomarker for the degree of coronary stenosis in ACS. Confirmation of observations in larger cohorts and longer follow-up periods is warranted.
微纤维相关蛋白（MFAP4）最初被鉴定为细胞外基质蛋白，已在多种人类疾病中得到证实，但在临床实践中尚未发现其与急性冠状动脉综合征（ACS）有关。因此，本研究旨在探讨循环 MFAP4 水平与 ACS 患者冠状动脉狭窄之间的关系。
我们纳入了 148 例 ACS 患者进行研究，包括 75 例 ST 段抬高型心肌梗死（STEMI）、27 例非 ST 段抬高型心肌梗死（non-STEMI）和 46 例不稳定型心绞痛（UA）。收集临床变量，并应用 Gensini 和 Syntax 狭窄评分系统评估冠状动脉狭窄的严重程度。采用 Kaplan-Meier 和 logistic 回归分析探讨 MFAP4 与冠状动脉狭窄严重程度或 ACS 结局之间的关系。采用 Spearman 分析描述 MFAP4 与临床参数之间的相关性。
STEMI 组（0.008ng/ml）循环 MFAP4 水平明显低于非 STEMI 组（0.014ng/ml）和 UA 组（0.019ng/ml）（p<0.001）。在校正混杂因素后，我们发现 MFAP4 是 STEMI 的独立危险因素（比值比=0.395，95%可信区间 0.174-0.895，p=0.026）。MFAP4 水平与 Gensini 评分和 Syntax 评分呈负相关（r=-0.311 和 -0.211，p<0.001 和 0.01）。根据 0.117ng/ml 的 MFAP4 水平，将 ACS 患者分为两组：低 MFAP4 组（<0.117ng/ml，n=60）和高 MFAP4 组（≥0.117ng/ml，n=88）。中位随访 165 天后，Kaplan-Meier 生存分析显示，MFAP4 水平较低的 ACS 患者无主要不良心血管事件（MACE）生存率显著降低（p=0.009）。
MFAP4 有望成为 ACS 患者冠状动脉狭窄程度的生物标志物。需要更大的队列和更长的随访时间来证实这些观察结果。
