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

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 vs. 209.98 ± 36.35, P < 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, P < 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.

Role of serum cytokines in the prediction of heart failure in patients with coronary artery disease

“…Tucker et al 43 reported that FGF‐21 is involved in the pathophysiology of HF by preventing oxidative stress, cardiac hypertrophy, and inflammation in cardiomyocytes and that its level is elevated in patients with HF, suggesting that FGF‐21 may be used as a biomarker for the prediction and diagnosis of HF. Another study found that the serum FGF21 levels were elevated in hospitalized patients with ST‐segment elevation myocardial infarction (STEMI), confirming that elevated serum FGF‐21 level may be a strong predictor of HF during hospitalization in patients with STEMI 44 . Together with our results, these reports suggest that FGF‐21 may serve as a biomarker that plays a pivotal role in CAD‐associated HF.…”

“…Another study found that the serum FGF21 levels were elevated in hospitalized patients with ST-segment elevation myocardial infarction (STEMI), confirming that elevated serum FGF-21 level may be a strong predictor of HF during hospitalization in patients with STEMI. 44 Together with our results, these reports suggest that FGF-21 may serve as a biomarker that plays a pivotal role in CAD-associated HF.…”

Mitochondrial dysfunction affects hepatic immune and metabolic remodeling in patients with hepatitis B virus-related acute-on-chronic liver failure

“…GDF15 and FGF21 Levels in tissue homogenates were examined to reveal mitochondrial dysfunction. GDF15 and FGF21 are circulating markers for mitochondrial disorders and are widely used in diagnosis of mitochondrial diseases[ 7 - 9 ] and other serious diseases, such as liver failure[ 4 , 10 , 11 ], heart failure[ 12 , 13 ], and sepsis[ 14 , 15 ]. Their expression levels positively correlated with disease severity.…”

Fibroblast growth factor 21 (FGF21): diagnostic, prognostic and therapeutic aspects in heart failure. A review

“…Площадь под кривой для FGF21, позволяющая предсказать развитие СН во время госпитализации у пациентов с ИМпST, составила 0,816 (95% ДИ 0,770-0,863). Таким образом, повышенные концентрации FGF21 в сыворотке крови являются значимым предиктором СН во время госпитализации у пациентов с ИМпST после экстренного чрескожного коронарного вмешательства [39].…”