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Deprecated: Implicit conversion from float 253.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 BMJ+Open 2017 ; 7 (11): ä Nephropedia Template TP
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Predictive value of apelin-12 in patients with ST-elevation myocardial infarction with different renal function: a prospective observational study #MMPMID29150476
Yang L; Zheng T; Wu H; Xin W; Mou X; Lin H; Chen Y; Wu X
BMJ Open 2017[]; 7 (11): ä PMID29150476show ga
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 ?apelin-12 (P=0.0115) and eGFR (P=0.0071) among patients with eGFR>90?mL/min×1.73?m2. Further analysis showed ?apelin-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.