A comparative analysis of cardiac bridging Integrator 1 (cBIN1) levels in patients with heart failure and healthy controls: A prospective case-control study

Objectives: To compare cardiac bridging integrator 1 (cBIN1) levels between healthy individuals and patients with heart failure (HF), and to assess changes in cBIN1 levels following therapeutic intervention to evaluate its potential as a diagnostic and prognostic biomarker. Methodology: A case-control study with three months follow-up was conducted in the Department of Physiology, Baqai University Hospital, Karachi, Pakistan, from June 2024 to November 2024. A total of 200 adults aged 40-70 years were recruited, comprising 50 healthy controls with left ventricular ejection fraction (LVEF ≥60%) and 150 patients with heart failure (HF): Heart failure with reduced, moderatly reduced and preserved ejection fraction, HFrEF (LVEF ≤40%), HFmrEF (LVEF 40-49%) and HFpEF (LVEF ≥50%). Enzyme linked immuno-essay (ELISA) was used to measure the plasma cBIN1 level at baseline. For the statistical analysis, ANOVA and t-tests, as well as post-hoc testing with significance at p<0.05, were used. Results: Mean plasma cBIN1 was 9.221±0.440 ng/mL in healthy controls, 1.193±0.059 in HFpEF, 1.009±0.063 in HFmrEF and 0.799±0.050 in HFrEF (p<0.001), with the lowest levels in HFrEF on post-hoc testing (p<0.001 for all comparisons against controls). Levels were significantly lower in participants with higher BMI (3.19±3.65 vs 0.99±0.20; t=2.084, p=0.038) and did not differ significantly by gender (p>0.05). No significant change was observed after three months of follow-up (p=0.963). Conclusion: Plasma cBIN1 levels were significantly lower in patients with heart failure than in healthy controls, with the lowest levels observed in HFrEF. These findings suggest that cBIN1 may have value in stratifying HF severity and warrant evaluation in larger, multicenter cohorts.