engleski

Influence of apelin-12 on troponin levels and the rate of MACE in STEMI patients

During acute myocardial infarction, phosphorylated TnI levels, Ca2+ sensivity and ATPase activity are decreased in the myocardium, and the subsequent elevation in Ca2+ levels actovates protease I (caplain I), leading to the proteolytic degradation of troponins. Concurently, the levels of apelin and APJ expression are increased by limiting myocardial injuri. In this prospective observational study, 100 consecutive patients with ST-elevation acute myocardial infarction were included. Patients meeting the 3 following criteria were included in our study: (1) continuous chest pain lasting >30 min, (2) observation of ST-segment elevation of more than 2 mm in two adjacend leads by ECG, (3) increased cardiac troponin I levels, and (4) patients who undferwent reperfusion therapy. We evaluated the levels of apelin-12 and troponin I on the first and seventh days after reperfusion therapy in all patients. Apelin-12 was inversely correlated with troponin I levels (Spearman's correlation= -0.40) with a p value <0.001. There was variability in the apelin values on the seventh day (Kruskal-Wallis test) based on major adverse cardiac events (MACE) (p=0.012). Using ROC curve analyses, a cut-off value of >2.2 for the association of apelin with MACE was determined, and the AUC was 0.71 (95% CI, 0.58- 0.84). Survival analysis using the Kaplan-Meier method showed a lower rate of MACE among patients with apelin levels >2.2 (p=0.002), and the ROC curve analysis showed a statistically significant difference in the are under the curve (p=0.004). The influence of apelin levels on troponin levels in the acute phase of STEMI in inversely correlated, whereas in the non-acute phase, low apelin values were associated with a high rate of MACE.

Apelin ; Myocardial infarction ; Major adverse cardiac events

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