Key result
High baseline FABP-3 linked to ~3.1-fold higher risk of renal decline in chronic coronary syndrome.
Why the study?
Renal dysfunction is common in CAD, and novel biomarkers like FABP-3 have been proposed for diagnosis and prognosis prediction due to shared vascular pathogenesis.
Does an elevated baseline FABP-3 level predict a >25% and >50% decline in eGFR in patients with chronic coronary syndrome?
Cohort (n=1,606)
Yes
Does an elevated baseline FABP-3 level predict a >25% and >50% decline in eGFR in patients with chronic coronary syndrome?
Hazard Ratio: 3.054 (95% CI 1.952–4.776)
Absolute Event Rate: 23.9% vs 6%
p-value: p=<0.001
Elevated baseline serum FABP-3 levels act as an independent predictor of subsequent renal function decline in patients with stable coronary artery disease.
May support FABP-3 for renal risk assessment in chronic coronary syndrome; leaves open added value over standard predictors.
BACKGROUND: Renal dysfunction is common in patients with coronary artery disease. Due to the shared vascular pathogenesis between the two conditions, novel biomarkers such as the fatty acid-binding protein-3 (FABP-3) have been proposed for diagnosis and prognosis prediction. This multicentre prospective cohort study investigates the association between FABP-3 and renal dysfunction. HYPOTHESIS: We hypothesized that higher FABP-3 levels are correlated to worse renal outcome. METHODS: Patients with chronic coronary syndrome were classified into three groups based on the initial serum FABP-3 levels. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to estimate the patient's renal function. Renal events were defined as >25% and >50% decline in estimated glomerular filtration rate (eGFR). Cox multivariable regression was employed to delineate the correlation between FABP-3 and renal dysfunction. RESULTS: A total of 1606 subjects were included. During a mean follow-up of 35.9 months, there were 239 patients with eGFR >25% reduction and 60 patients with >50% reduction. In the Kaplan-Meier survival curve and log-rank test, increased levels of FABP-3 were significantly correlated with eGFR >25% reduction (p < .001) and >50% reduction (p < .001). Multivariate Cox regression model revealed that subjects with higher FABP-3 exhibited a greater risk of eGFR >25% reduction (Group 2: hazard ratio [HR] = 2.328, 95% confidence interval [CI] = 1.521-3.562, p < .001; Group 3: HR = 3.054, 95% CI = 1.952-4.776, p < .001) and >50% reduction (Group 3: HR = 4.838, 95% CI = 1.722-13.591, p = .003). CONCLUSIONS: Serum FABP-3 may serve as a novel biomarker to predict eGFR decline in patients with chronic coronary syndrome.
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Yeh et al. (2024) conducted a cohort in Chronic coronary syndrome (n=1,606). Elevated serum FABP-3 levels (highest tertile) vs. Lowest tertile of serum FABP-3 levels was evaluated on >25% decline in estimated glomerular filtration rate (eGFR) by CKD-EPI equation (HR 3.054, 95% CI 1.952-4.776, p=<0.001). In patients with chronic coronary syndrome, high baseline serum FABP-3 levels were independently associated with a >25% reduction in eGFR compared to low levels (HR 3.054).
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