Correlation between plasma copine 3 levels and coronary collateral circulation in patients with chronic total occlusion

HU Run-xuan; GUO Zi-tong; JIANG Hao-yan; ZHANG Rong; Aliyanmu AHENIYAZI; TAO Jing; YANG Yi-ning

doi:10.3969/j.issn.1672-5301.2026.02.003

Abstract：Objective To investigate the association between plasma Copine3(CPNE3)levels and the formation of coronary collateral circulation(CCC)in patients with chronic total occlusion(CTO),as well as to evaluate its predictive value for major adverse cardiovascular events(MACE).Methods We conducted a retrospective cohort study involving 122 CTO patients diagnosed via coronary angiography at the People's Hospital of Xinjiang Uygur Autonomous Region from January to August 2024.Patients were categorized into two groups based on Rentrop classification:a poor CCC group(Rentrop grade 0～1,n=59)and a good CCC group(Rentrop grade 2～3,n=63).Plasma CPNE3 concentration was measured using enzyme-linked immunosorbent assay.Logistic regression analysis was performed to identify factors influencing CCC formation,while the predictive efficacy of CPNE3 was assessed using receiver operating characteristic(ROC)curve analysis.Additionally,Cox regression analysis was employed to identify risk factors for MACE.Results Plasma CPNE3 levels were significantly higher in the good CCC group compared to the poor CCC group[(2739.19±962.522)pg/ml vs.(2157.75±707.842)pg/ml,P<0.001].Multivariate analysis identified CPNE3 as an independent predictor of CCC formation(adjusted OR=2.604,95%CI 1.441-4.706,P=0.002).A negative correlation was observed between CPNE3 and coronary lesion severity(Gensini score r=-0.216,P=0.017).ROC curve analysis indicated that the optimal CPNE3 cut-off value for predicting good CCC was 1975.3 pg/ml(AUC=0.689).The incidence of MACE was significantly lower in the high CPNE3 expression group(≥1975.3 pg/ml)compared to the low expression group(14.3%vs.30.5%,P=0.031).Multivariate Cox regression revealed that CPNE3 acts as an independent protective factor against MACE(adjusted HR=0.215,95%CI 0.091-0.510,P=0.034).Conclusion Plasma CPNE3 levels are closely associated with CCC formation and clinical prognosis in CTO patients.CPNE3 may serve as a potential biomarker for evaluating collateral compensatory capacity and predicting MACE risk,providing a novel basis for risk stratification in this patient population.