Dataset Information

A high circulating FGF21 level as a prognostic marker in patients with acute myocardial infarction.

ABSTRACT:

Objective

The purpose of this study was to examine the level of serum FGF21 in acute myocardial infarction (AMI) and to explore the association between serum FGF21 and major adverse cardiovascular events in AMI patients.

Methods

A total of 238 Chinese patients were recruited for this study between January 2016 and June 2016, including 183 AMI patients and 55 patients without AMI were enrolled in this study. The level of serum FGF21 was measured by ELISA. Patients were followed-up after admission using a standardized protocol that included Outpatient follow-up and telephone contacts to record the Major Adverse Cardiovascular Events (MACEs). Finally, 165 patients were enrolled and followed up during the period of 24 months.

Results

Circulating FGF21 level was elevated in the AMI patients compared to control (P < 0.05). Multivariate linear regression analysis showed that cTnI (? = -0.001, 95% CI = 0.021-0.001, P = 0.002), fibrinogen (? = -0.055, 95% CI = 0.098-0.013, P = 0.011) and hyperlipidemia (? = 0.129, 95% CI = 0.014-0.243, P = 0.011) were the independent risk factors for the serum of FGF21 in AMI patients. After follow-up, A Kaplan-Meier analysis showed that the all-cause mortality rate was not significantly different between the two groups (P = 0.4146). Meanwhile the rate of cardiovascular events was significantly higher in the high-FGF21 group than in the low-FGF21 group (P = 0.0399). In the multivariate Cox proportional hazards regression model suggested that the predictive independent risk factors for the occurrence of MACEs were FGF21 ? cut-off (HR: 1.637; 95% CI: 1.357-3.647, P = 0.029) and D-Dimer (HR: 1.420; 95% CI: 1.069-3.014, P = 0.046).

Conclusion

Circulating FGF21 level is elevated in the AMI patients. In AMI patients, cTnI, fibrinogen and hyperlipidemia are the inde pendent risk factors for the serum of FGF21. Higher circulating FGF21 level is associated with increased MACEs rate. This study suggests that circulating FGF21 level may be a predictive marker of the clinical outcomes in AMI patients.

SUBMITTER: Chen H

PROVIDER: S-EPMC6176227 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

A high circulating FGF21 level as a prognostic marker in patients with acute myocardial infarction.

Chen Haifeng H Lu Nan N Zheng Meifan M

American journal of translational research 20180915 9

<h4>Objective</h4>The purpose of this study was to examine the level of serum FGF21 in acute myocardial infarction (AMI) and to explore the association between serum FGF21 and major adverse cardiovascular events in AMI patients.<h4>Methods</h4>A total of 238 Chinese patients were recruited for this study between January 2016 and June 2016, including 183 AMI patients and 55 patients without AMI were enrolled in this study. The level of serum FGF21 was measured by ELISA. Patients were followed-up ...[more]

PMID: 30323882

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Project description:Background Shock is associated with the activation of the coagulation and fibrinolytic system, and D-dimer is the degradation product of cross-linked fibrin. However, the prognostic value of D-dimer in patients with cardiogenic shock (CS) after acute myocardial infarction (AMI) remains unclear. Methods We retrospectively analyzed the data of consecutive patients with CS complicating AMI. The primary endpoint was 30-day mortality and the secondary endpoint was the major adverse cardiovascular events (MACEs) including 30-day all-cause mortality, ventricular tachycardia/ventricular fibrillation, atrioventricular block, gastrointestinal hemorrhage, and non-fatal stroke. Restricted cubic spline (RCS) analyses were performed to assess the association between admission D-dimer and outcomes. A multivariable Cox regression model was performed to identify independent risk factors. The risk predictive potency with D-dimer added to the traditional risk scores was evaluated by C-statistics and the net reclassification index. Results Among 218 patients with CS complicating AMI, those who died during the 30-day follow-up presented with worse baseline characteristics and laboratory test results, including a higher level of D-dimer. According to the X-tile program result, the continuous plasma D-dimer level was divided into three gradients. The 30-day all-cause mortality in patients with low, medium, and high levels of D-dimer were 22.4, 53.3, and 86.2%, respectively (p < 0.001 for all). The 30-day incidence of MACEs was 46.3, 77.0, and 89.7%, respectively (p < 0.001). In the multivariable Cox regression model, the trilogy of D-dimer level was an independent risk predictor for 30-day mortality (median D-dimer cohort: HR 1.768, 95% CI 0.982–3.183, p = 0.057; high D-dimer cohort: HR 2.602, 95% CI 1.310–5.168, p = 0.006), a similar result was observed in secondary endpoint events (median D-dimer cohort: HR 2.012, 95% CI 1.329–3.044, p = 0.001; high D-dimer cohort: HR 2.543, 95% CI 1.452–4.453, p = 0.001). The RCS analyses suggested non-linear associations of D-dimer with 30-day mortality. The enrollment of D-dimer improved risk discrimination for all-cause death when combined with the traditional CardShock score (C-index: 0.741 vs. 0.756, pdifference = 0.004) and the IABP-SHOCK II score (C-index: 0.732 vs. 0.754, pdifference = 0.006), and the GRACE score (C-index: 0.679 vs. 0.715, pdifference < 0.001). Similar results were acquired after logarithmic transformed D-dimer was included in the risk score. The improvements in reclassification which were calculated as additional net reclassification index were 7.5, 8.6, and 12.8%, respectively. Conclusion Admission D-dimer level was independently associated with the short-term outcome in patients with CS complicating AMI and addition of D-dimer brought incremental risk prediction value to traditional risk prediction scores.

Project description:ObjectiveTo determine prognostic role of endothelial progenitor cells (EPCs) in intensive care patients with acute myocardial infarction (AMI).Materials and methodsFrom December 2018 to July 2021, a total of 91 eligible patients with AMI were consecutively examined in a single intensive care unit (ICU) in China. Patients with a history of acute coronary artery disease were excluded from the study. Samples were collected within 24 hr of onset of symptoms. EPCs, defined as coexpression of CD34+/CD133+ cells or CD133+/CD34+/KDR+, were studied using flow cytometry and categorized by quartiles. Based on the 28-days mortality outcome, the patients were further divided into two groups: death and survival. The study incorporated various variables, including cardiovascular risk factors such as body mass index, hypertension, diabetes, hypercholesterolemia, atherosclerotic burden, and medication history, as well as clinical characteristics such as APACHEⅡscore, central venous-arterial carbon dioxide difference (GAP), homocysteine, creatinine, C-reactive protein, HbAlc, and cardiac index. Cox regression analysis was employed to conduct a multivariate analysis.ResultsA total of 91 patients with AMI who were admitted to the ICU were deemed eligible for inclusion in the study. Among these patients, 23 (25.3%) died from various causes during the follow-up period. The counts of EPCs were found to be significantly higher in the survival group compared to the death group (P < 0.05). In the univariate analysis, it was observed that the 28-days mortality rate was associated with the several factors, including the APACHEⅡscore (P=0.00), vasoactive inotropic score (P=0.03), GAP (P=0.00), HCY (P=0.00), creatinine (P=0.00), C-reactive protein (P=0.00), HbAlc (P=0.00), CI (P=0.01), quartiles of CD34+/CD133+ cells (P=0.00), and quartiles of CD34+/CD133+/KDR+ cells (P=0.00). CD34+/CD133+/KDR+ cells retained statistical significance in Cox regression models even after controlling for clinical variables (HR: 6.258 × 10-10 and P=0.001). Nevertheless, no significant correlation was observed between CD34+/CD133+ cells and all-cause mortality.ConclusionsThe decreased EPCs levels, especially for CD34+/CD133+/KDR+ cells subsets, were an independent risk factor for 28-days mortality in AMI patients.

Dataset Information

A high circulating FGF21 level as a prognostic marker in patients with acute myocardial infarction.

Objective

Methods

Results

Conclusion

Publications

A high circulating FGF21 level as a prognostic marker in patients with acute myocardial infarction.

Similar Datasets

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