RESUMO
BACKGROUND: Fibulin1 and fibulin5 are extracellular glycoproteins from the fibulin family. Both are expressed in the vessel wall and protect against vascular damage. AIMS: We aimed to investigate whether fibulin1 and 5 may be used to exclude non-STsegment elevation myocardial infarction (NSTEMI) in the emergency setting. METHODS: The study included 48 patients in the NSTEMI group and 42 controls who presented with chest pain of noncardiac origin as confirmed by a comprehensive evaluation including coronary angiography. Blood samples for fibulin1, fibulin5, and troponin I measurements were drawn on admission to the emergency department. RESULTS: Demographic characteristics were similar in patients with NSTEMI and controls. The median levels of both glycoproteins were lower in patients with NSTEMI as compared with controls: fibulin1, 96.9 µg/ml (interquartile range [IQR], 20-503 µg/ml) vs 111.5 (IQR, 71-457 µg/ml), P = 0.01, and fibulin5, 38 ng/ml (IQR, 15-509 ng/ml vs 57 ng/ml (IQR, 26-631 ng/ml), P <0.001. The receiver operating characteristic curve analysis revealed the cutoff value of 105.6 µg/ml for fibulin1 and of 49.4 ng/ml for fibulin5 to exclude NSTEMI on admission. CONCLUSIONS: The present study demonstrated that fibulin1 and -5 measurements might be used to exclude NSTEMI in patients admitted to the emergency department with acute chest pain.