Circulating Phoenixin-14 demonstrated outstanding discrimination for severe coronary artery disease, achieving an AUC of 0.969 (95% CI 0.888-0.997) at a threshold of ≤20.2 pg/mL.
Observational (n=90)
No
Does circulating Phoenixin-14 improve diagnostic discrimination of coronary artery disease severity in patients undergoing coronary angiography?
Circulating Phoenixin-14 demonstrates high diagnostic accuracy for identifying severe coronary artery disease, outperforming other novel biomarkers.
Effect estimate: AUC 0.969 (95% CI 0.888-0.997)
Early identification of anatomically significant coronary artery disease (CAD) remains a major clinical challenge despite advances in cardiovascular diagnostics. Novel circulating biomarkers may improve risk stratification and diagnostic discrimination beyond conventional parameters. We investigated the diagnostic utility of four emerging biomarkers—Phoenixin-14, Syntenin-1, Alamandine, and Cerebellin-1—for the assessment of CAD severity. In this prospective observational study, 90 participants undergoing coronary angiography were categorized into three groups: severe CAD (≥70% stenosis; n = 30), non-obstructive/non-critical CAD (<70% stenosis; n = 30), and angiographically normal controls (n = 30). Patients with acute coronary syndrome, diabetes mellitus, prior coronary revascularization, cardiomyopathy, or significant systemic disease were excluded. Circulating biomarker concentrations were quantified using the enzyme-linked immunosorbent assay. Comparative analyses, correlation testing, and receiver operating characteristic (ROC) analyses were performed to evaluate discriminatory performance. Circulating Phoenixin-14 concentrations progressively declined across the control, non-critical CAD, and severe CAD groups 40.1 (29.0–49.7) vs. 24.4 (18.5–30.1) vs. 16.7 (13.4–19.0) pg/mL, respectively; p < 0.001. Phoenixin-14 demonstrated outstanding discrimination for severe CAD, achieving an area under the ROC curve (AUC) of 0.969 (95% CI, 0.888–0.997), with 86.7% sensitivity and 96.7% specificity at a threshold of ≤20.2 pg/mL. Diagnostic performance was substantially lower for Syntenin-1 (AUC, 0.795), Alamandine (AUC, 0.661), and Cerebellin-1 (AUC, 0.597). Phoenixin-14 also showed robust discrimination for non-critical CAD (AUC, 0.832). Biomarker concentrations exhibited correlations with metabolic indices while remaining largely independent of traditional cardiovascular risk factors. Among the evaluated novel circulating biomarkers, Phoenixin-14 demonstrated superior diagnostic performance for both obstructive and non-obstructive CAD, markedly outperforming Syntenin-1, Alamandine, and Cerebellin-1. These findings identify Phoenixin-14 as a promising candidate biomarker for CAD severity assessment and clinical risk stratification. Larger multicenter studies are warranted to validate these exploratory findings and determine their incremental value in contemporary cardiovascular practice.
Polat et al. (Wed,) conducted a observational in Coronary artery disease (n=90). Circulating Phoenixin-14 vs. Angiographically normal controls and non-obstructive CAD was evaluated on Discrimination for severe CAD (≥70% stenosis) (AUC 0.969, 95% CI 0.888-0.997). Circulating Phoenixin-14 demonstrated outstanding discrimination for severe coronary artery disease, achieving an AUC of 0.969 (95% CI 0.888-0.997) at a threshold of ≤20.2 pg/mL.