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血清 FGF21 水平升高可预测 STEMI 患者急诊经皮冠状动脉介入治疗后住院期间心力衰竭的发生。

Elevated serum FGF21 levels predict heart failure during hospitalization of STEMI patients after emergency percutaneous coronary intervention.

机构信息

The Jiangyin Clinical College, Xuzhou Medical University, Jiangyin, Jiangsu, China.

出版信息

PeerJ. 2023 Feb 6;11:e14855. doi: 10.7717/peerj.14855. eCollection 2023.

Abstract

BACKGROUND

Fibroblast growth factor 21 (FGF21) has multiple cardioprotective effects including modulation of glucolipid metabolism, anti-inflammation, and anti-oxidative stress, but its association with the heart failure during hospitalization in patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) has not been reported.

METHODS

A total of 348 STEMI patients treated with emergency PCI were included from January 2016 to December 2018. Relevant biochemical indicators were measured by central laboratory. Serum FGF21 levels were measured by ELISA. The occurrence of heart failure during hospitalization was recorded. Patients' cardiac function was assessed by echocardiography.

RESULTS

Serum FGF21 levels were significantly higher in the STEMI group with heart failure than in the group without heart failure (249.95 ± 25.52 . 209.98 ± 36.35, < 0.001). Serum FGF21 levels showed a strong positive correlation with N-terminal precursor B-type natriuretic peptide (NT-proBNP) in STEMI patients (r = 0.749, < 0.001). FGF21 was found to be an independent risk factor for the development of heart failure during hospitalization in STEMI patients by binary logistic regression analysis. The area under curve (AUC) for FGF21 to predict the development of heart failure during hospitalization in STEMI patients was 0.816 (95% CI [0.770-0.863]) according to the receiver operating characteristic (ROC) curve analysis.

CONCLUSION

Elevated serum FGF21 levels have been shown to be a strong predictor of heart failure during hospitalization in patients with STEMI after emergency PCI.

摘要

背景

成纤维细胞生长因子 21(FGF21)具有多种心脏保护作用,包括调节糖脂代谢、抗炎和抗氧化应激,但它与接受急诊经皮冠状动脉介入治疗(PCI)的 ST 段抬高型心肌梗死(STEMI)患者住院期间心力衰竭的关系尚未见报道。

方法

本研究纳入了 2016 年 1 月至 2018 年 12 月期间接受急诊 PCI 治疗的 348 例 STEMI 患者。中心实验室检测相关生化指标,酶联免疫吸附法(ELISA)检测血清 FGF21 水平。记录住院期间心力衰竭的发生情况,超声心动图评估患者心功能。

结果

心力衰竭组 STEMI 患者血清 FGF21 水平显著高于无心衰组(249.95±25.52比 209.98±36.35, < 0.001)。STEMI 患者血清 FGF21 水平与 N 末端脑钠肽前体(NT-proBNP)呈强正相关(r=0.749, < 0.001)。二元逻辑回归分析显示,FGF21 是 STEMI 患者住院期间发生心力衰竭的独立危险因素。根据受试者工作特征(ROC)曲线分析,FGF21 预测 STEMI 患者住院期间心力衰竭发生的曲线下面积(AUC)为 0.816(95%CI[0.770-0.863])。

结论

血清 FGF21 水平升高可强烈预测急诊 PCI 后 STEMI 患者住院期间心力衰竭的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ed5/9910186/270d81f11cb4/peerj-11-14855-g001.jpg

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