Department of Cardiology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China.
BMC Cardiovasc Disord. 2021 Jan 7;21(1):24. doi: 10.1186/s12872-020-01839-w.
The present study aimed to assess the correlation of fibroblast growth factor (FGF)-23 expression with clinical characteristics, then further explore its value in predicting 2-year in-stent restenosis (ISR) risk in coronary heart disease (CHD) patients underwent percutaneous coronary intervention (PCI) with drug-eluting stent (DES).
In this prospective, single-center, observational study, totally 214 CHD patients treated by PCI with DES were consecutively recruited, and peripheral blood samples were collected prior to PCI with DES for serum samples isolation. Following, FGF-23 level in the serum samples was detected via enzyme linked-immuno-sorbent Assay. The follow-up coronary angiography was performed at 1 year and 2 years after PCI or if suspected ISR symptoms occurred.
FGF-23 was positively correlated with fasting blood-glucose, insulin resistance, serum creatinine, serum uric acid, LDL-C, high-sensitivity C-reactive protein, cardiac troponin I and N-terminal-proB-type natriuretic peptide, while was negatively associated with HDL-C and left ventricular ejection fraction (all P < 0.01). Furthermore, FGF-23 was positively correlated with hypercholesteremia, hyperuricemia and family history of CAD (all P < 0.05). However, it did not correlate with other chronic complications, biochemical indexes, lesion features or PCI parameters (all P > 0.05). Moreover, FGF-23 level was higher in 2-year ISR patients (n = 38) compared to 2-year non-ISR patients (n = 176) (P < 0.001), and receiver operating characteristic curve indicated that FGF-23 was of good value in predicting 2-year ISR risk (AUC 0.828, 95% CI 0.761-0.896).
FGF-23 correlates with endocrine and metabolism dysregulation, worse cardiac and renal function, inflammation level, stenosis degree of target lesion, and serves as an independent risk factor for 2-year ISR risk in CHD patients underwent PCI with DES.
本研究旨在评估成纤维细胞生长因子 23（FGF-23）表达与临床特征的相关性，然后进一步探讨其在预测经皮冠状动脉介入治疗（PCI）置入药物洗脱支架（DES）后冠心病（CHD）患者 2 年支架内再狭窄（ISR）风险中的价值。
本前瞻性、单中心、观察性研究连续纳入 214 例 CHD 患者，在 PCI 置入 DES 前采集外周血样本分离血清。采用酶联免疫吸附试验检测血清样本中 FGF-23 水平。PCI 后 1 年和 2 年行冠状动脉造影随访，或出现疑似 ISR 症状时行冠状动脉造影随访。
FGF-23 与空腹血糖、胰岛素抵抗、血肌酐、血尿酸、低密度脂蛋白胆固醇、高敏 C 反应蛋白、心肌肌钙蛋白 I 和 N 末端 B 型利钠肽原呈正相关，与高密度脂蛋白胆固醇和左心室射血分数呈负相关（均 P<0.01）。此外，FGF-23 与高胆固醇血症、高尿酸血症和 CAD 家族史呈正相关（均 P<0.05）。然而，FGF-23 与其他慢性并发症、生化指标、病变特征或 PCI 参数均无相关性（均 P>0.05）。此外，2 年 ISR 患者（n=38）的 FGF-23 水平高于 2 年非 ISR 患者（n=176）（P<0.001），ROC 曲线表明 FGF-23 对预测 2 年 ISR 风险具有良好的价值（AUC 0.828，95%CI 0.761-0.896）。
FGF-23 与内分泌和代谢紊乱、心肾功能恶化、炎症水平、靶病变狭窄程度相关，是 CHD 患者 PCI 置入 DES 后 2 年 ISR 风险的独立危险因素。
