Value of serum NT-IGFBP-4 for non-invasive risk stratification of coronary heart disease and predictive efficiency for complexity of coronary artery lesions

Background We aimed to explore the value of serum N-terminal insulin-like growth factor-binding protein 4 (NT-IGFBP-4) in the non-invasive risk stratification of coronary heart disease and its predictive efficiency for the complexity of coronary artery lesions [assessed by Synergy between PCI with TAXUS and Cardiac Surgery (SYNTAX) and SYNTAX II scores]. Methods Subjects (180 in total) were recruited from patients treated between September 2023 and September 2024. Serum NT-IGFBP-4 level was measured. SYNTAX and SYNTAX II scores were assessed. Results The serum NT-IGFBP-4 level, SYNTAX score, and SYNTAX II score of the high-risk group were significantly higher than those of medium- and low-risk groups ( p <0.001). The patients with more affected vessels had higher NT-IGFBP-4 levels. Univariate analysis of variance showed that NT-IGFBP-4 level was significantly different among the three risk groups (F=18.991, p <0.001), with a linear trend ( p <0.001). Spearman rank correlation analysis showed that NT-IGFBP-4 level was positively correlated with the risk stratification (r=0.420, p <0.001). Multivariate logistic regression analysis showed that NT-IGFBP-4 level, SYNTAX score, and three-vessel disease were independent predictors of coronary artery lesions ( p <0.05). ROC curve analysis showed that the areas under the curves of NT-IGFBP-4, SYNTAX score, and three-vessel disease were all >0.700. Conclusions Serum NT-IGFBP-4 reflects the pathophysiological state of coronary heart disease when combined with the SYNTAX II scoring system. It shows a significant positive correlation with the risk of coronary heart disease and can independently predict this risk.