Serum Fibroblast Growth Factor 21 as a Novel Biomarker in Prediction of Coronary Artery Disease Severity

Aims: To evaluate serum FGF-21 concentrations in coronary heart disease patients (CHD) whether or not associated with diabetes and/or hypertension. It also investigated the possible association between serum FGF21 and the coronary angiographic findings in terms of number of coronary vessels affected.

Study Design: Cross-sectional observational comparative study.

Place and Duration of Study: Coronary angiography unit at the Critical Care Department with Biochemistry Department, Kasr Al Aini Medical Hospitals, from January 2013 to March 2014.

Methods: Seventy patients (47 Males and 23 females) were classified after coronary angiography into: Sub-group (A): Coronary Artery Disease patients without DM or hypertension; Sub-group (B): Coronary Artery Disease patients with DM and/or hypertension; Sub-group (C): Patients with normal angiography but suffering from DM and/ or hypertension. Twelve healthy individuals were also included in the present study as a control group. Body Mass Index (BMI) were matched for all groups, systolic and diastolic blood pressure (SBP&DBP) and fasting serum levels of FGF21, glucose, insulin and lipid profile were estimated.

Results: A significant increase in the levels of FGF-21 was detected in CHD patients compared to control group (325.8 ± 129.2 Vs 202.2 ± 65.8, P =.002) and significant increase was also found in those with multi-vessel disease affection compared to those with one-vessel affection group (392.1 ± 140.4 Vs 250.7 ± 83.8, P=.007), There was a highly significant positive correlation between serum levels of FGF-21 and each of BMI (r= .7, P > .001), SBP (r= .63, P > .001), and DBP (r= .67, P > .001). ROC curve analysis indicated that the optimum cut off value for plasma FGF 21 level in patients with CHD versus control was 236 pg/ml which gives 68.33% sensitivity and 75% specificity.

Conclusion: Circulating FGF21 level could be a biomarker for CHD and may be used for assessment of severity of CHD.