Serum fibulin-1 levels and target organ damage in patients at high cardiovascular risk: A prospective observational study.

Background: Fibulin-1, an extracellular matrix protein, is a potential biomarker for cardiovascular disease, but its association with target organ damage (TOD) in high-risk patients remains unclear.

Methods: We prospectively analysed 330 patients undergoing invasive coronary angiography (ICA) (mean age, 64.7 ± 10.7 years; female, 37.9%). Blood samples obtained just before invasive coronary angiography (ICA) were stored for subsequent measurement of fibulin-1 levels using an enzyme-linked immunosorbent assay. During index admission, eight TOD parameters (obstructive coronary artery disease, impaired kidney function, increased arterial stiffness, left ventricular hypertrophy, left ventricular diastolic dysfunction and arterial occlusive disease of peripheral arteries) were assessed. Long-term clinical follow-up data on major adverse cardiovascular events (MACE) were also collected.

Results: Fibulin-1 levels were significantly higher in patients with multiple TOD compared to those without (506 ± 229 vs. 354 ± 148 mcg/mL; p < .001). Serum fibulin-1 levels increased proportionally with the number of TODs (p < .001). Multivariable analyses identified that each 100 mcg/mL increase in serum fibulin-1 level was significantly associated with an increased risk of multiple TOD, even after adjustment for potential confounders (odds ratio: 1.29-1.45; p < .05). Similarly, each 100 mcg/mL increase in serum fibulin-1 level was associated with a 29% higher incidence of MACE (95% confidence interval, 1.14-1.46; p < .001).

Conclusions: Fibulin-1 is strongly associated with the extent of TOD and may serve as a useful biomarker for risk stratification in high-risk patients.