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Predictive value of apelin-12 in patients with ST-elevation myocardial infarction with different renal function: a
Lingchang Yang1, Ting Zheng1, Haopeng Wu1
1Department of Emergency Medicine, The First People's Hospital of Taizhou, Taizhou, Zhejiang, China.
Insights
Low levels of apelin-12 predict major adverse cardiovascular events (MACEs) in ST-segment elevation myocardial infarction (STEMI) patients post-primary percutaneous coronary intervention (pPCI). This finding is particularly relevant for patients with normal estimated glomerular filtration rate (eGFR).
Area of Science:
- Cardiology
- Biomarkers
- Interventional Cardiology
Background:
- Apelin-12 is crucial for cardiovascular homeostasis, but its prognostic significance is not well-established.
- Understanding predictors of adverse events after ST-segment elevation myocardial infarction (STEMI) is vital for patient outcomes.
Purpose of the Study:
- To identify factors predicting major adverse cardiovascular events (MACEs) following primary percutaneous coronary intervention (pPCI) in STEMI patients.
- To evaluate the prognostic value of apelin-12 levels in this patient cohort.
Main Methods:
- A cohort of 464 STEMI patients undergoing successful pPCI were followed for 2.5 years.
- Multivariate Cox regression and ROC curve analyses were employed to determine independent predictors of MACEs.
Main Results:
- Low apelin-12 levels were identified as an independent predictor of MACEs (HR=0.132, P<0.001).
- Other significant predictors included low left ventricular ejection fraction, low estimated glomerular filtration rate (eGFR), Killip's classification >I, and pathological Q-wave.
- Low apelin-12 also predicted poorer in-hospital prognosis and MACEs, especially in patients with normal eGFR.
Conclusions:
- Lower apelin-12 levels are associated with an increased risk of MACEs in STEMI patients treated with pPCI.
- The prognostic value of apelin-12 is particularly pronounced in patients with normal eGFR, highlighting its potential as a predictive biomarker.
Objectives:
To investigate factors predicting the onset of major adverse cardiovascular events (MACEs) after primary percutaneous coronary intervention (pPCI) for patients with ST-segment elevation myocardial infarction (STEMI) .
Background:
Apelin-12 plays an essential role in cardiovascular homoeostasis. However, current knowledge of its predictive prognostic value is limited.
Methods:
464 patients with STEMI (63.0±11.9 years, 355 men) who underwent successful pPCI were enrolled and followed for 2.5 years. Multivariate cox regression analysis and receiver operating characteristic (ROC) curve analysis were performed to determine the factors predicting MACEs.
Results:
118 patients (25.4%) experienced MACEs in the follow-up period. Multivariate cox regression analysis found low apelin-12 (HR=0.132, 95% CI 0.060 to 0.292, P<0.001), low left ventricular ejection fraction (HR=0.965, 95% CI 0.941 to 0.991, P=0.007), low estimated glomerular filtration rate (eGFR) (HR=0.985, 95% CI 0.977 to 0.993, P<0.001), Killip's classification>I (HR=0.610, 95% CI 0.408 to 0.912, P=0.016) and pathological Q-wave (HR=1.536, 95% CI 1.058 to 2.230, P=0.024) were independent predictors of MACEs in the 2.5 year follow-up period. Low apelin-12 also predicted poorer in-hospital prognosis and MACEs in the 2.5 years follow-up period compared with Δapelin-12 (P=0.0115) and eGFR (P=0.0071) among patients with eGFR>90 mL/min×1.73 m2. Further analysis showed Δapelin-12 <20% was associated with MACEs in patients whose apelin-12 was below 0.76 ng/mL (P=0.0075) on admission.
Conclusions:
Patients with STEMI receiving pPCI with lower apelin-12 are more likely to suffer MACEs in hospital and 2.5 years postprocedure, particularly in those with normal eGFR levels.
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