Predictive Value of Adiponectin for Long-Term MACEs in Non-Diabetic STEMI Patients

Background: A decreased level of adiponectin is known as a predictor of adverse left ventricular remodeling and major adverse cardiac events (MACEs). We evaluated long-term MACEs following ST-segment elevation myocardial infarction (STEMI) in relation to adiponectin levels. Methods: This prospective study included a total of 73 consecutive STEMI patients. Adiponectin, CK, CK-MB, cTnI, CRP, HDL cholesterol, LDL cholesterol, triglycerides, and other routine laboratory parameters were considered, and myocardial revascularization and two-dimensional echocardiography were performed. Subjects were divided into two groups according to their serum adiponectin concentrations. Results: In total, 24 (32.87%) patients suffered from MACEs, 19 (26.02%) with adiponectin value ≤ 1.8 ng/mL (group 1) and 5 (6.84%) with adiponectin value > 1.8 ng/mL (group 2) (p < 0.013). Heart failure (Killip >1) was present in 14 cases (19.17%) in group 1 and in 3 cases (4.1%) in group 2 (p < 0.001). Kaplan-Meier analysis was used to depict the occurrence of MACEs according to the adiponectin threshold identified during hospitalization (1.8 ng/mL). The log-rank test revealed a statistically significant difference in survival between groups (p = 0.013), and the AUC value for adiponectin was 0.77 (95% CI, 0.66-0.89), p = 0.01. Based on univariate logistic regression analysis, adiponectin and BMI were significantly associated with MACEs (p = 0.018, p = 0.034). Multivariate logistic regression analysis shows that serum adiponectin predicts MACEs after STEMI (p = 0.011). Conclusions: We found significant associations between adiponectin levels and MACEs in patients who survived STEMI. The established cut-off value of 1.8 ng/mL for adiponectin during hospitalization identified patients at risk for MACEs.