Jing Shi, Ping Gong, Kang Ye, Zhongsheng Zhu

Department of Cardiology, Guangming Traditional Chinese Medicine Hospital, Pudong New Area, Shanghai, 201399, People’s Republic of China

Correspondence: Zhongsheng Zhu, Department of Cardiology, Guangming Traditional Chinese Medicine Hospital, Pudong New Area, No. 43, Dongmen Street, Shanghai, 201399, People’s Republic of China, Tel +86-18117209753, Email drzzs66@163.com

Background: This study aimed to assess the association between serum fibulin-5 levels and the progression of coronary artery disease (CAD) and its potential role as a diagnostic biomarker.
Methods: This study was conducted by the Department of Cardiology at Shanghai Pudong Hospital, enrolling 186 patients diagnosed with CAD and 150 healthy controls. Clinical and biochemical parameters were compared between the groups using Student’s t-test. ELISA was used to quantify serum fibulin-5 levels. Pearson’s correlation and logistic regression analyses were conducted to assess the relationship between fibulin-5 levels and CAD-related indicators.
Results: Compared to healthy individuals, patients with CAD exhibited significantly higher levels of body mass index (BMI), systolic blood pressure (SBP), fasting blood glucose (FBG), white blood cell (WBC) count, high-sensitivity C-reactive protein (hs-CRP), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), intima-media thickness (IMT), brachial-ankle pulse wave velocity (baPWV), and fibulin-5, along with reduced flow-mediated dilation (FMD) and high-density lipoprotein cholesterol (HDL-C) (all P< 0.05). Patients with CAD involving > 2 vessels showed significantly elevated SBP, hs-CRP, TG, TC, LDL-C, IMT, baPWV, and fibulin-5, and lower HDL-C and FMD than those with CAD involving ≤ 2 vessels (P < 0.05). ELISA results demonstrated significantly increased fibulin-5 levels in patients with CAD, with the highest levels in the > 2 vessels group. ROC analysis identified a fibulin-5 cutoff value of 64.2 ng/mL, achieving 93% sensitivity and 72% specificity (AUC = 0.950) for differentiating CAD progression from healthy controls. Fibulin-5 levels were positively correlated with age, hs-CRP, TC, LDL-C, IMT, and baPWV, and negatively correlated with FMD. Multivariate logistic regression identified SBP, IMT, baPWV, and fibulin-5 as independent risk factors for CAD involving > 2 vessels (P < 0.05).
Conclusion: Serum fibulin-5 levels were significantly elevated in patients with CAD involving > 2 vessels compared to healthy subjects and were positively correlated with disease progression.

Keywords: fibulin-5, coronary artery disease, intima-media thickness, disease progression, biomarkers