Visfatin Related to the Severity of Non-ST-Segment Elevation Acute Coronary Syndrome: A Retrospective Study of 164 Patients at a Tertiary Chest Pain Center

Abstract

Acute coronary syndrome (ACS) poses a pervasive threat to individuals grappling with cardiovascular afflictions, manifesting as unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI), ST-segment elevation myocardial infarction (STEMI), or sudden cardiac death, depending on vascular obstruction’s extent and location. NSTEMI, closely linked to substantial morbidity and mortality, has become the primary cause of hospitalization in ischemic heart disease patients. Swift prognostication of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) is crucial, necessitating the identification of precise markers. This study, conducted from January 2020 to March 2021, explored the correlation between serum visfatin levels and NSTE-ACS severity. A total of 164 patients undergoing coronary angiography were enrolled, with a control group (n = 55) exhibiting less than 50% coronary stenosis. NSTE-ACS patients were categorized based on angiography outcomes into single-vessel (n = 41), double-vessel (n = 28), and multivessel (n = 40) groups. Serum visfatin levels, meticulously quantified, showed significant elevation in NSTE-ACS patients (n = 109) compared to the control group (n = 55) (P<0.01). Visfatin correlated positively with the GRACE score (r = 0.397, P<0.01). In the multivessel disease group, visfatin levels were notably higher (P<0.01). After adjusting for cardiovascular risk factors, visfatin emerged as an independent predictor of affected coronary arteries (OR 0.205; 95% CI 0.032–0.378; P=0.02). Receiver-operating characteristic (ROC) curves demonstrated enhanced prognostic ability when combining visfatin with age, hypertension, and diabetes for multivessel disease (AUC: 0.839, sensitivity: 65.0%, specificity: 89.7%, P<0.001). Elevated serum visfatin in NSTE-ACS patients suggests its role as an independent harbinger for the number of affected coronary arteries, potentially indicating severity in NSTE-ACS patients.