Elevated serum FGF21 predicts the major adverse cardiovascular events in STEMI patients after emergency percutaneous coronary intervention

Lingyun Gu,Wenlong Jiang,Huidong Qian,Ruolong Zheng,Weizhang Li

doi:10.7717/peerj.12235

Abstract

BackgroundAlthough 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.MethodsA 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.ResultsSerum FGF21 levels were significantly higher in the STEMI group than in the SA group (225.03 ± 37.98 vs. 135.51 ± 34.48, P < 0.001). Multiple linear regression analysis revealed that serum FGF21 levels were correlated with NT-proBNP (P < 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.ConclusionElevated FGF21 levels on admission have been shown to be a powerful predictor of MACEs for STEMI patients after emergency PCI.

Highlights

Acute myocardial infarction (AMI) is one of the most common cardiovascular emergencies, with a high mortality and disability rate
No differences were observed in sex, age, incidence of atrial fibrillation, levels of triglycerides, total cholesterol, uric acid, creatinine, pulmonary pressure, mitral regurgitation, interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT) and left ventricular end-diastolic volume (LVEDV) between the segment elevation myocardial infarction (STEMI) and stable angina (SA) groups
low-density lipoprotein cholesterol (LDL-C) and NT-proBNP levels were markedly higher in the STEMI group than in the SA group, while the high-density lipoprotein cholesterol (HDL-C) levels were lower in the STEMI group than in the SA group

Summary

Introduction

Acute myocardial infarction (AMI) is one of the most common cardiovascular emergencies, with a high mortality and disability rate. Elevated serum FGF21 predicts the major adverse cardiovascular events in STEMI patients after emergency percutaneous coronary intervention. Another liver-secreted cytokine with anti-inflammatory effects, fibroblast growth factor 21 (FGF21), has gained increasing interest in recent cardiovascular research. 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

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