Diagnostic and prognostic value of cardiospecific integrator protein in patients after myocardial infarction

Abstract

Introduction. Evaluation of the new biomarker cBIN-1(CS) has advantages; its concentration does not depend on volume status, body weight, CKD, in contrast to natriuretic peptides, which seems valuable in the diagnosis of HF.Aim. To study the diagnostic and prognostic value of serum cBIN-1(CS) in patients who have suffered myocardial infarction.Materials and methods. The study analyzed clinical, laboratory and instrumental data of 100 patients on the 7th day after myocardial infarction. Subgroup I included patients with a history of HF, subgroup II included patients with risk factors for developing HF. Studies included echocardiography, TSH, cBIN-1(CS) determination. Over the course of 18 months, clinical outcomes were recorded for participants: a composite endpoint of death due to cardiac causes, incident ADHF, worsening TSH results, and intensification of pharmacotherapy.Results. In patients with a history of HF, the level of cBIN-1(CS) in the blood was 0.871 ng/ml, in the group with risk factors for HF – 0.690 ng/ml. The results of TSH on day 7 are associated with an increase in cBIN-1(CS) content and a decrease in the result by 80.45 m in the STEMI group and by 177.36 m in the NSTEMI group (p = 0.002). ROC-analysis of the probability of a fatal outcome based on the cBIN-1(CS) level showed the area under the ROC curve in subgroup I with an established diagnosis of HF of 0.743 ± 0.098 (p = 0.023), in subgroup II – 0.746 ± 0.146 (p = 0.103). ROC-analysis of the probability of achieving the composite endpoint for each of the patient subgroups showed AUC of 0.859 ± 0.058 and 0.751 ± 0.063 (p < 0.001), respectively. The cBIN-1(CS) value ≥ 0/826 ng/ml (sensitivity 80.0%, specificity 70.6%) can be considered as a marker of unfavorable outcome after myocardial infarction. According to the Kaplan-Meier survival curve for patients after MI, the cut-off value for cBIN-1(CS) is 0.826 ng/ml (p < 0.0001), which was determined to be the most optimal for separating patients into high and low risk of an adverse outcome.Conclusion. The cBIN-1(CS) biomarker has high sensitivity and specificity and can be used as a marker for assessing myocardial reserve after myocardial infarction to predict adverse events.