Clinical study of serum FGF21 combined with NT-proBNP in predicting in-stent restenosis after second-generation drug-eluting stent implantation
Yang Guijiu
Chen Honglei
Zou Lijiao
Zhong Yanzhu
Chen Yuewu
Abstract：Objective To investigate the relationship between serumfibroblast growth factor(FGF-21)and in stent restenosis(ISR)after second-generation drug eluting stent(DES)implantation,as well as the value of combining N-terminal proBNP to predict ISR.Methods One hundred and seventy-five patients with coronary heart disease(CAD)who under-went second-generation DES percutaneous coronary intervention(PCI)in the Cardiovascular Department of the Second Af-filiated Hospital of Hainan Medical College from January 2019 to June 2021 were selected.Peripheral blood samples were col-lected before DES PCI,and serum FGF21 levels were detected by enzyme-linked immunosorbent assay.Coronary angiogra-phy was reexamined 9 to 24 months after PCI,and 32 cases were divided into an ISR group and 143 cases in a non ISR group based on the occurrence of ISR.Application of Generalized Additive Model(GAM)to explore the relationship be-tween FGF-21 and ISR risk,multivariate logistic regression analysis of clinical factors affecting 2-year DES ISR risk in CAD patients,and receiver operating characteristic(ROC)curve analysis of its predictive value.Results The serum FGF21 level in the ISR group was higher than that in the non ISR group(Z=7.081,P<0.001).The results of multivariate logistic regres-sion analysis showed that the total length of the stent≥38 mm,elevated NT-proBNP,and FGF21 were independent predic-tive factors for the 2-year increased risk of DES ISR in CAD patients[OR(95%CI)=1.072(1.040-1.106),1.004(1.002-1.007),1.038(1.021-1.056)].The fitting curve between serum FGF21 level and 2-year DES ISR incidence showed a positive correlation(r=0.508,P<0.001).The area under the curve(AUC)of serum FGF21 predicting 2-year DES ISR risk is 0.891,the AUC of NT proBNP is 0.739,and the AUC predicted by FGF21 combined with NT proBNP is 0.966(P<0.001).Conclusion Serum FGF21 is an independent risk factor for 2-year ISR risk in CAD patients receiving second-generation DES PCI treat-ment.The combination of FGF21 and NT proBNP has higher predictive potential for DES ISR.
Keywords：Coronary heart diseaseFibroblast growth factor-21Drug-eluting stent implantationIn-stent resteno-sisRisk factor
Publication Date：2024-03-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 266-271 )