Baseline fibroblast growth factor 23 is associated with long-term mortality in ST-elevation myocardial infarction-results from the augsburg myocardial infarction registry

Timo Schmitz; Bastian Wein; Margit Heier; Annette Peters; Christa Meisinger; Jakob Linseisen

doi:10.3389/fcvm.2023.1173281

Baseline fibroblast growth factor 23 is associated with long-term mortality in ST-elevation myocardial infarction-results from the augsburg myocardial infarction registry

Front Cardiovasc Med. 2023 Aug 4:10:1173281. doi: 10.3389/fcvm.2023.1173281. eCollection 2023.

Authors

Timo Schmitz¹, Bastian Wein², Margit Heier^{3

4}, Annette Peters^{4

5

6

7}, Christa Meisinger¹, Jakob Linseisen¹

Affiliations

¹ Epidemiology, Medical Faculty, University of Augsburg, Augsburg, Germany.
² Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany.
³ KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany.
⁴ Helmholtz Zentrum München, Institute for Epidemiology, Neuherberg, Germany.
⁵ Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany.
⁶ German Center for Diabetes Research (DZD), Neuherberg, Germany.
⁷ German Research Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany.

Abstract

Background: The aim of this study was to investigate the association between inflammatory plasma protein concentrations and long-term mortality in patients with ST-elevation myocardial infarction (STEMI).

Methods: For 343 STEMI patients recorded between 2009 and 2013 by the population-based Myocardial Infarction Registry Augsburg, 92 inflammatory plasma proteins were measured at the index event using the OLINK inflammation panel. In multivariable-adjusted Cox regression models, the association between each plasma protein and all-cause long-term mortality was investigated. Median follow-up time was 7.6 (IQR: 2.4) years. For plasma protein that showed a strong association with long-term mortality, a 5-year survival ROC analysis was performed.

Results: One plasma protein, namely Fibroblast Growth Factor 23 (FGF-23), was particularly well associated with long-term mortality in the multivariable-adjusted Cox model with an FDR-adjusted p-value of <0.001 and a Hazard Ratio (HR) of 1.57 [95% CI: 1.29-1.91]. In the 5-years ROC analysis, an AUC of 0.6903 [95% CI: 0.594-0.781] was estimated for FGF-23. All other plasma protein didńt show strong associations, each marker with FDR-adjusted p-values >0.05 in the multivariable-adjusted Cox models.

Conclusions: FGF-23 is independently associated with long-term mortality after STEMI and might play an important role in the response to myocardial injury. The results suggest FGF-23 to be a useful marker in the long-term treatment of STEMI patients and a potential target for drug development.

Keywords: FGF-23; STEMI; inflammatory plasma protein; long-term mortality; myocardial infarction.

Grants and funding

This work was supported by the Helmholtz Zentrum München, German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education, Science, Research and Technology and by the State of Bavaria. This research also received support from the Medical Faculty, University of Augsburg, and the University Hospital of Augsburg, Germany. Since the year 2000, the collection of MI data has been co-financed by the German Federal Ministry of Health to provide population-based MI morbidity data for the official German Health Report (see http://www.gbe-bund.de). Moreover, this study was supported by the DZHK (German Centre for Cardiovascular Research) and by the BMBF (German Ministry of Education and Research). The open access publication of this article was supported by the Open Access Fund of the Medical Faculty of the University of Augsburg.