Author + information
- Liangping Zhao1,
- Haizhou Shu1,
- Biao Yao1,
- Maosong Wang1,
- Yuqi Chen1,
- Weiting Xu1,
- Jianchang Chen1 and
- Liangping Zhao1
Adiponectin is an identified secreted protein implicated in the regulation of insulin resistance, and had correlation with atherosclerosis. The impact of adiponection on the clinical outcome in patients with acute myocardial infarction (AMI) remains controversial. The primary objective of this study was to investigate the predictive value of serum adiponectin level on morbidity of AMI, and to evaluate its impact on prognosis in patients with AMI after percutaneous coronary intervention (PCI).
We prospectively recruited patients with acute ST segment elevation myocardial infarction (STEMI) underwent primary PCI. The arterial blood samples were taken after successful insertion of the sheath but before emergency coronary angiography. The serum adiponectin level was measured by enzyme-linked immunosorbent assay. The myocardial perfusion was quantified with thrombolysis in myocardial infarction (TIMI) grade and one hour ST-segment resolution after PCI. Major adverse cardiac events (MACE) were recorded including cardiac death, recurrent nonfatal myocardial infarction, target vessel revascularization, and readmission for heart failure after 18 months’ followed-up.
108 consecutive patients with STEMI and 38 control patients without coronary artery stenosis were recruited. Serum adiponectin level in STEMI group was significantly lower than that in control (1413.9±218.8 vs 1756.3±205.5 pg/ml, P<0.001). Multiple logistic regression analysis revealed that lower serum adiponectin level was an independent predictor of STEMI (AOR=0.992 95%CI=0.987∼0.996, P=0.001).
The mean one hour ST-segment resolution rate after PCI were 54.4%±29.3%, and 68 (63.0%) patients had ≥50% ST-segment resolution rate. The post-PCI TIMI grade includes 3 (2.8%) patients with grade 1, 22 (20.4%) with grade 2, 83 (76.8%) with grade 3. Serum adiponectin level in <50% ST-segment resolution rate group was significantly lower than that in ≥50% ST-segment resolution rate group (1322.4±178.3 vs 1467.8±223.6 pg/mL, P=0.001). Patients with post-PCI TIMI grade 0-2 had lower serum adiponectin level than those with TIMI grade 3 (1350.7±214.9 vs 1430.6±218.5 pg/mL, P=0.007).
MACE occurred in 22 patients (20.4%) including 4 cardiac death, 3 recurrent nonfatal myocardial infarction, 2 target vessel revascularization, and 13 readmission for heart failure after 18 months’ followed-up. Serum adiponectin level in MACE group was significantly lower than that in non-MACE group (1331.5±203.0 vs 1435.0±218.8 pg/mL, P=0.037). Cox regression analysis revealed that lower serum adiponectin level remained an independent predictor of MACE (AOR=0.996 95%CI=0.993∼0.999, P=0.003).
Lower serum adiponectin level was significantly associated with morbidity of STEMI and adverse prognosis in patients with acute myocardial infarction.