Zhao Xiaoxiao, Zhao Hanjun, Chen Runzhen, Zhou Jinying, Li Nan, Li Jiannan, Yan Shaodi, Liu Chen, Zhou Peng, Chen Yi, Song Li, Yan Hongbing
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, BeiJing, People's Republic of China.
Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, ShenZhen, People's Republic of China.
J Inflamm Res. 2025 Feb 4;18:1589-1608. doi: 10.2147/JIR.S494049. eCollection 2025.
The protein known as Fatty Acid-Binding Protein 4 (FABP4), predominantly found in adipocytes, macrophages, and endothelial cells, has emerged as a pivotal biomarker linking inflammation and metabolism in the context of cardiovascular diseases.
The present investigation sought to elucidate the influence of FABP4 on the prognostic ramifications for patients experiencing ischemic vascular events, which encompass ischemic cerebrovascular occurrences, myocardial infarctions, and cardiovascular mortality.
A total of 1102 consecutive patients diagnosed with acute myocardial infarction (AMI) and aged over 55 years were prospectively enrolled from March 2017 to January 2020. Initially, participants were stratified into three groups according to the tertile levels of FABP4, followed by further categorization based on various lipid profiles and specific inflammatory markers.
On follow-up (median 751 days, maximum 1506 days), a total of 158 ischemic events were recorded. 1) In multivariable models meticulously adjusted for age, gender, traditional coronary heart disease factors, Killip classification, and discharge medications, the association of elevated levels of FABP4 (Tertile 3 HR 1.618 [1.061 to 2.468], p=0.026), augmented concentrations of PTX3 (Tertile 3 HR 1.811 [1.211 to 2.710], p=0.004), or LL-37 (Tertile 3 HR 0.651 [0.433 to 0.981], p=0.040) with ischemic risk was markedly intensified. 2) Multivariate HRs associated with 1 standard deviation (SD) (mg/dL) increase in the FABP4 parameters were as follows in different subgroups. 1-SD difference in FABP4 was associated with a 23%, 23%, 21 and 29% increase in ischemic events over after fully adjusted the confounding risk factors among male, patients with hyperlipidemia, hypertension and diabetes respectively. 3) The Kaplan-Meier curve demonstrated significant differences between the tertiles of FABP4 index levels among all enrolled participants (p=0.0180).
This study reinforces the utility of FABP4 for enhancing risk stratification specifically among older patients diagnosed with ST-elevation myocardial infarction.
脂肪酸结合蛋白4（FABP4）主要存在于脂肪细胞、巨噬细胞和内皮细胞中，已成为心血管疾病背景下连接炎症和代谢的关键生物标志物。
本研究旨在阐明FABP4对经历缺血性血管事件患者预后的影响，这些事件包括缺血性脑血管事件、心肌梗死和心血管死亡。
2017年3月至2020年1月，前瞻性纳入了1102例年龄超过55岁、诊断为急性心肌梗死（AMI）的连续患者。最初，根据FABP4的三分位数水平将参与者分为三组，然后根据各种血脂谱和特定炎症标志物进一步分类。
在随访期间（中位751天，最长1506天），共记录了158例缺血性事件。1） 在对年龄、性别、传统冠心病因素、Killip分级和出院用药进行精心调整的多变量模型中，FABP4水平升高（三分位数3，HR 1.618 [1.061至2.468]，p=0.026）、PTX3浓度升高（三分位数3，HR 1.811 [1.211至2.710]，p=0.004）或LL-37（三分位数3，HR 0.651 [0.433至0.981]，p=0.040）与缺血风险的关联显著增强。2） 在不同亚组中，FABP4参数每增加1个标准差（SD）（mg/dL）的多变量HR如下。在对男性、高脂血症患者、高血压患者和糖尿病患者的混杂风险因素进行完全调整后，FABP4的1-SD差异分别与缺血事件增加23%、23%、21%和29%相关。3） Kaplan-Meier曲线显示，所有纳入参与者中FABP4指数水平的三分位数之间存在显著差异（p=0.0180）。
本研究强化了FABP4在增强风险分层方面的效用，特别是在诊断为ST段抬高型心肌梗死的老年患者中。
