Liu Hai-Tao, Chen Mai, Yu Jin, Li Wei-Jie, Tao Ling, Li Yan, Guo Wen-Yi, Wang Hai-Chang
From the Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Medicine (Baltimore). 2015 Jan;94(4):e449. doi: 10.1097/MD.0000000000000449.
The cardiovascular profile of the apelin makes it a promising therapeutic target for heart failure and ischemic heart disease. However, it remains unknown whether apelin affect the clinical outcome of patients with ST elevation myocardial infarction (STEMI) and received percutaneous coronary intervention (PCI). We enrolled a total of 120 patients with acute STEMI who underwent primary PCI. Serum apelin was detected. After PCI procedure, all patients were followed for 12 months. The follow-up end-point was occurrence of major adverse cardiovascular event (MACE). Lower serum apelin levels (<0.54 ng/mL) was significantly associated with higher serum low density lipoprotein-cholesterol level, higher peak creatine kinase MB fraction (CK-MB) and peak troponin-I (TNI) levels, the number of obstructed vessels, and need for inotropic support. The incidence of MACE was significantly higher in the low apelin group (23 patients out of 67) than in the high apelin group (10 patients out of 75, P < 0.001). Kaplan-Meier analysis revealed that the MACE-free rate was significantly lower in the patients with low apelin than those with high apelin (P < 0.001, log rank test). The multivariate Cox proportional hazard analysis adjusted with the clinical and angiographic characteristic reveals that the serum low apelin is a predictor for MACE incidence (hazard ratio = 2.36, 95% confidence interval: 1.83-3.87, P = 0.004). The finding of this study suggests that the serum apelin may be used as a marker to predict the MACE after PCI in patients with STEMI.
阿佩林的心血管特征使其成为心力衰竭和缺血性心脏病一个有前景的治疗靶点。然而,阿佩林是否会影响ST段抬高型心肌梗死(STEMI)且接受经皮冠状动脉介入治疗(PCI)患者的临床结局仍不清楚。我们共纳入了120例行直接PCI的急性STEMI患者。检测血清阿佩林水平。PCI术后,对所有患者进行12个月的随访。随访终点为主要不良心血管事件(MACE)的发生情况。较低的血清阿佩林水平(<0.54 ng/mL)与较高的血清低密度脂蛋白胆固醇水平、较高的肌酸激酶同工酶MB峰值(CK-MB)和肌钙蛋白I峰值(TNI)水平、阻塞血管数量以及使用正性肌力药物支持的需求显著相关。低阿佩林组的MACE发生率(67例中有23例)显著高于高阿佩林组(75例中有10例,P<0.001)。Kaplan-Meier分析显示,低阿佩林患者的无MACE率显著低于高阿佩林患者(P<0.001,对数秩检验)。经临床和血管造影特征校正的多变量Cox比例风险分析显示,血清低阿佩林是MACE发生率的一个预测指标(风险比=2.36,95%置信区间:1.83-3.87,P=0.004)。本研究结果表明,血清阿佩林可作为预测STEMI患者PCI术后MACE的一个标志物。