Key result
Elevated baseline RBP4 levels (highest vs. lowest quartile) were independently associated with a significantly increased risk of major adverse cardiovascular events at 3 years post-PCI in patients with acute myocardial infarction (HR 4.41).
Why the study?
Few studies have explored the predictive role of circulating retinol-binding protein 4 (RBP4) in adverse outcomes in acute myocardial infarction (AMI) patients after percutaneous coronary intervention (PCI).
Does elevated baseline RBP4 predict an increased risk of MACEs in patients with AMI after successful PCI?
Cohort (n=736)
No
Does elevated baseline RBP4 predict an increased risk of MACEs in patients with AMI after successful PCI?
Answers are grounded in this paper and cite their sources.
Elevated baseline serum RBP4 levels are an independent predictor of short- and long-term major adverse cardiovascular events in patients with AMI undergoing PCI, suggesting its utility for risk stratification.
AIM: This study explored the association between retinol-binding protein 4 (RBP4) and cardiovascular events in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). METHODS: A total of 736 AMI patients who underwent successful PCI were prospectively enrolled between January 2020 and January 2022. The baseline RBP4 levels were measured by ELISA and categorized into quartiles. The incidence of major adverse cardiovascular events (MACEs), including all-cause mortality, recurrent myocardial infarction, revascularization, heart failure, and stroke, was assessed at the 1- and 3-year follow-up. Multivariate Cox proportional hazards models were used to evaluate the association between RBP4 and MACEs. A receiver operating characteristic (ROC) curve analysis was performed to determine the predictive efficiency of RBP4 for predicting the 1-year and 3-year MACEs. RESULTS: During follow-up, 110 (14.95%) and 165 (22.42%) patients developed MACEs at one and three years, respectively. Elevated RBP4 (the fourth quartile vs. the first quartile) was associated with an increased risk of MACEs (HR = 2.18, 95%CI = 1.42~4.37, P = 0.007) and heart failure (HR = 3.89, 95%CI = 1.68~5.75, P＜0.001) at the 1-year follow-up. Additionally, the elevated RBP4 were associated with an increased risk of MACEs (HR = 4.41, 95%CI = 2.57~7.31, P＜0.001), revascularization (HR = 3.43, 95%CI = 1.82~4.87, P＜0.001) and heart failure (HR = 7.12, 95%CI = 3.78~11.92, P＜0.001) at 3-year follow-ups. An ROC curve analysis revealed that the serum RBP4 cutoff for predicting the 1-year MACEs was 46.3 ng/mL (AUC = 0.74, 95%CI = 0.69~0.78, P＜0.001), and for predicting the 3-year MACEs, it was 43.9 ng/mL (AUC = 0.81, 95%CI = 0.77~0.85, P＜0.001). A Stratified Cox regression analysis suggested that the renal function did not significantly modify the association between RBP4 and MACEs. CONCLUSION: Elevated RBP4 levels are independently associated with an increased risk of MACEs in patients with AMI post-PCI, thus highlighting its potential as a prognostic biomarker for risk stratification.
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Lu et al. (2026) conducted a cohort in Acute myocardial infarction post-PCI (n=736). Elevated Retinol-binding protein 4 (RBP4) levels (fourth quartile) vs. Lower RBP4 levels (first quartile) was evaluated on Major adverse cardiovascular events (MACEs) at 3 years (HR 4.41, 95% CI 2.57-7.31, p=<0.001). Elevated baseline RBP4 levels (highest vs. lowest quartile) were independently associated with a significantly increased risk of major adverse cardiovascular events at 3 years post-PCI in patients with acute myocardial infarction (HR 4.41).
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