FGF-21: a novel biomarker predicting no-reflow in ST-segment elevation myocardial infarction

Area of Science:

• Cardiology
• Biochemistry
• Medical Diagnostics

Background:

• Primary percutaneous coronary intervention (pPCI) is crucial for ST-elevation myocardial infarction (STEMI) but can result in the no-reflow (NR) phenomenon.
• Fibroblast Growth Factor 21 (FGF-21) is a key metabolic regulator influencing glucolipid metabolism and insulin sensitivity.

Purpose of the Study:

• To investigate the predictive capability of FGF-21 for the development of NR in STEMI patients undergoing pPCI.
• To assess FGF-21 as a potential biomarker for NR phenomenon.

Main Methods:

• A case-control study involving 91 STEMI patients undergoing pPCI and 45 healthy controls.
• STEMI patients were categorized into NR (n=46) and non-NR (n=45) groups.
• Serum FGF-21 levels were measured and analyzed alongside white blood cell count and hs-CRP.

Main Results:

• STEMI patients with NR exhibited significantly higher serum FGF-21 levels compared to non-NR and control groups (p=0.001).
• Multivariate analysis identified hs-CRP, age, and serum FGF-21 as independent predictors of NR.
• FGF-21 levels demonstrated high sensitivity (87%) and specificity (88%) in predicting NR formation (AUC: 0.897).

Conclusions:

• Elevated FGF-21 levels are strongly associated with the no-reflow phenomenon in STEMI patients.
• FGF-21 emerges as a novel and potent predictor for NR development post-pPCI.
• This finding highlights FGF-21's potential role in managing STEMI prognosis.