PT  - JOURNAL ARTICLE
AU  - Yang, Lingchang
AU  - Zheng, Ting
AU  - Wu, Haopeng
AU  - Xin, Wenwei
AU  - Mou, Xiongneng
AU  - Lin, Hui
AU  - Chen, Yide
AU  - Wu, Xiaoyu
TI  - Predictive value of apelin-12 in patients with ST-elevation myocardial infarction with different renal function: a prospective observational study
AID  - 10.1136/bmjopen-2017-018595
DP  - 2017 Nov 01
TA  - BMJ Open
PG  - e018595
VI  - 7
IP  - 11
4099  - http://bmjopen.bmj.com/content/7/11/e018595.short
4100  - http://bmjopen.bmj.com/content/7/11/e018595.full
SO  - BMJ Open2017 Nov 01; 7
AB  - 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 Δapelin-12 (P=0.0115) and eGFR (P=0.0071) among patients with eGFR>90 mL/min×1.73 m2. Further analysis showed Δapelin-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.