Low adiponectin blood concentration predicts left ventricular remodeling after ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.

BACKGROUND

Left ventricular remodeling (LVR), an increase in left ventricular end-diastolic volume index > or = 20%, is an adverse consequence of myocardial infarction. The aim of this study was to assess the association between LVR and adiponectin, which has been shown to protect against myocardial ischemia-reperfusion injury.

METHODS

In 75 patients echocardiographic examination was performed one year after ST-segment elevation myocardial infarction, successfully treated with primary percutaneous coronary intervention (pPCI). Two groups of patients were analyzed: those with LVR (n = 15) and those without LVR (n = 60).

RESULTS

The predictors of LVR were: anterior myocardial infarction, glucose at admission, baseline C-reactive protein, adiponectin, and echocardiographic parameters: left ventricular end-diastolic and end-systolic volume indices, ejection fraction < 40% and left ventricular wall motion score index (WMSI) at discharge. On multivariable regression analysis, lower adiponectin level (OR = 0.67, 95% CI 0.49-0.91, p < 0.05) and higher WMSI (OR = 20.14, 95% CI 2.62-154.82, p < 0.01) were the only independent negative predictors of LVR. The optimal cut-off for adiponectin for predicting LVR was < or = 4.7 mg/mL (sensitivity: 73%, specificity: 85%) and this level increased the risk of LVR 15-fold (95% CI 4.05-59.87, p = 0.0001).

CONCLUSIONS

Baseline low blood adiponectin concentration, along with WMSI, can be considered as a predictor of the LVR in male patients one year after myocardial infarction and pPCI.