Correlation between serum cerebral dopamine neurotrophic factor levels and severity of coronary artery lesions in acute myocardial infarction

Background: Acute myocardial infarction (AMI) remains a leading cause of death and disability worldwide, and current biomarkers such as troponin, while sensitive, have limitations in early risk stratification and prognostic assessment. Cerebral dopamine neurotrophic factor (CDNF) is a neurotrophic protein that exerts cytoprotective effects under endoplasmic reticulum stress in preclinical models, but its role in human AMI has not been investigated. This study aimed to measure serum CDNF levels in patients with acute coronary syndrome (ACS), evaluate its diagnostic value for AMI, and assess its relationship with coronary lesion severity and short-term prognosis.

Methods: A total of 141 ACS patients (72 AMI, 69 non-AMI) were enrolled. Serum CDNF was measured at admission, 24 h, and 96 h. Least absolute shrinkage and selection operator (LASSO)-logistic regression was used to build a diagnostic model. Prognostic endpoints were defined as hard Major Adverse Cardiovascular and Cerebrovascular Events (MACCE) [cardiac death, recurrent myocardial infarction (MI), stroke, ischemia-driven revascularization] during 6-month follow-up.

Results: Admission CDNF was higher in AMI [3.43±2.23 vs. 2.45±1.37 ng/mL, P=0.01; area under the curve (AUC) =0.622]. The LASSO-logistic model achieved an AUC of 0.938. CDNF correlated with Gensini score (r=0.362, P<0.001). In prognosis analysis, patients with favorable outcomes had higher CDNF at 24 and 96 h. A logistic model incorporating CDNF24h and left atrial diameter predicted prognosis (AUC =0.801).

Conclusions: CDNF is elevated in AMI and correlates with infarct severity. It provides incremental diagnostic value beyond conventional markers. A dual role (damage marker vs. protective factor) is suggested.