血清FGF21、Irisin在ST段抬高型心肌梗死合并心力衰竭患者中的水平变化及其诊断效能分析OA

Objective To investigate the diagnostic value of serum fibroblast growth factor 21(FGF21)and Irisin in patients with ST-segment elevation myocardial infarction(STEMI)complicated by heart failure(HF).Methods A total of 162 STEMI patients admitted to Handan First Hospital from June 2022 to June 2023 were enrolled.Based on the occurrence of heart failure within 48 hours after admission,they were divided into a control group(without HF,99 cases)and a study group(with HF,63 cases).Serum levels of FGF21 and Irisin were measured by enzyme-linked immunosorbent assay(ELISA).Pearson correlation analysis was performed to assess the correlation between FGF21 and Irisin,as well as their correlations with cardiac function parameters.Multivariate Logistic regression was performed to identify factors influencing STEMI complicated by HF.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the diagnostic performance of FGF21 and Irisin for STEMI complicated by HF.Results Compared with the control group,the study group had significantly higher serum FGF21 level(t=20.267,P<0.05)and lower Irisin level(t=16.149,P<0.05).Patients with Killip class Ⅲ-Ⅳ exhibited higher FGF21 level(t=9.673,P<0.05)and lower Irisin level(t=7.809,P<0.05)than those with class Ⅱ.The study group also showed greater LVEDD and IVST(t=3.820,5.260;P<0.05),and lower LVEF(t=6.503,P<0.05)than the control group.Pearson analysis revealed that FGF21 was positively correlated with LVEDD and IVST(r=0.548,0.496;P<0.05),and negatively correlated with LVEF and Irisin(r=-0.529,-0.651;P<0.05).Irisin was negatively correlated with LVEDD and IVST(r=-0.618,-0.523;P<0.05),and positively correlated with LVEF(r=0.525,P<0.05).Multiple Logistic regression identified Irisin(OR=0.661,95%CI=0.491-0.890)and LVEF(OR=0.543,95%CI=0.376-0.783)as protective factors,while FGF21(OR=2.684,95%CI=1.376-5.237),LVEDD(OR=3.124,95%CI=1.407-6.937),and a history of diabetes(OR=2.349,95%CI=1.419-3.887)were risk factors for STEMI with HF.ROC curve analysis showed that the areas under the curve(AUC)for diagnosing STEMI complicated by HF were 0.738(95%CI=0.662-0.814)for FGF21,0.797(95%CI=0.728-0.866)for Irisin,and 0.850(95%CI=0.790-0.910)for their combination.The combined model demonstrated superior diagnostic performance compared to either biomarker alone(Z=3.051,2.823;P<0.05).Conclusion Serum FGF21 level is elevated,while Irisin level is decreased in STEMI patients complicated by HF.Both biomarkers are influencing factors for STEMI complicated by HF,and their combination shows high diagnostic value for this condition.