Gu Lingyun, Jiang Wenlong, Qian Huidong, Zheng Ruolong, Li Weizhang
Department of Cardiology, Jiangyin Hospital Affiliated to Southeast University, Jiangyin, Jiangsu, China.
PeerJ. 2021 Sep 30;9:e12235. doi: 10.7717/peerj.12235. eCollection 2021.
Although there have been several studies related to serum fibroblast growth factor 21 (FGF21) levels and acute myocardial infarction, the value of serum FGF21 levels in ST-segment elevation myocardial infarction (STEMI) patients after emergency percutaneous coronary intervention (PCI) has not been previously investigated.
A total of 348 STEMI patients who underwent emergency PCI were enrolled from January 2016 to December 2018. The primary endpoint was the occurrence of major adverse cardiovascular events (MACEs), with a median follow-up of 24 months. Eighty patients with stable angina (SA) who underwent selective PCI served as the control group. Serum FGF21 levels were measured by ELISA.
Serum FGF21 levels were significantly higher in the STEMI group than in the SA group (225.03 ± 37.98 vs. 135.51 ± 34.48, < 0.001). Multiple linear regression analysis revealed that serum FGF21 levels were correlated with NT-proBNP ( < 0.001). According to receiver operating characteristic (ROC) analysis, the areas under the ROC curve (AUCs) of FGF21 and NT-proBNP were 0.812 and 0.865, respectively. The Kaplan-Meier curves showed that STEMI patients with lower FGF21 levels had an increased MACE-free survival rate. Cox analysis revealed that high FGF21 levels (HR: 2.011, 95% CI: [1.160-3.489]) proved to be a powerful tool in predicting the risk of MACEs among STEMI patients after emergency PCI.
Elevated FGF21 levels on admission have been shown to be a powerful predictor of MACEs for STEMI patients after emergency PCI.
尽管已有多项关于血清成纤维细胞生长因子21（FGF21）水平与急性心肌梗死的研究，但血清FGF21水平在ST段抬高型心肌梗死（STEMI）患者急诊经皮冠状动脉介入治疗（PCI）后的价值此前尚未得到研究。
选取2016年1月至2018年12月期间接受急诊PCI的348例STEMI患者。主要终点为主要不良心血管事件（MACE）的发生，中位随访时间为24个月。选取80例接受选择性PCI的稳定型心绞痛（SA）患者作为对照组。采用酶联免疫吸附测定法（ELISA）检测血清FGF21水平。
STEMI组血清FGF21水平显著高于SA组（225.03±37.98 vs. 135.51±34.48，<0.001）。多元线性回归分析显示血清FGF21水平与N末端脑钠肽前体（NT-proBNP）相关（<0.001）。根据受试者工作特征（ROC）分析，FGF21和NT-proBNP的ROC曲线下面积（AUC）分别为0.812和0.865。Kaplan-Meier曲线显示FGF21水平较低的STEMI患者无MACE生存率增加。Cox分析显示，高FGF21水平（HR：2.011，95%CI：[1.160 - 3.489]）被证明是预测急诊PCI后STEMI患者发生MACE风险的有力工具。
入院时FGF21水平升高已被证明是急诊PCI后STEMI患者发生MACE的有力预测指标。
