The Change Of Apelin During The PCI In Patients With Acute Myocardial Infarction

Background and purpose of researchIn pace with the improvement of living standard and the increase of working pressure and the bad dietary habits and the bad habits and customs contribute to the increase in morbidity of acute myocardial infarction(AMI). Due to the superiority of Thrombolytic therapy and Percutaneous coronary intervention(PCI) and Coronary artery bypass surgery, makes them come into wide use in AMI patients with ischemia reperfusion therapy. PCI fast effective reperfusion has become the first chose of AMI. Howerver, PCI still leads to the occurrence of myocardial reperfusion injury. The patients of diabetes who have hyperinsulinemia and the increase of myocardial vulnerability. Whether there are discrepancies in reperfusion after PCI and changes of the body cytokines is not clear and definite.As the Small molecules active peptide of new discovery, Apelin is the endogenic ligand of APJ(puative recepotor protein realated to the angiotensin recepotor AT1,APJ) which have important regulating function for cardiovascular such as bring down blood pressure and vasodilation and strengthen myocardiac contraction and Myocardial preservation and protect myocardial cells and vascular endothelial cells.The purpose of research is to observe expression changes of apelin of perioperative blood plasma of the patients of AMI. To analyze the relevance between the expression of of apelin of blood plasma and prognosis of the patients with AMI complicated with type 2 diabetes(T2DM). To discuss the protection of apelin in PCI. MethodsContinuous collected 375 cases of patients as patient group who had coronary heart disease have accepted coronary angiography with a diagnosis of AMI and successful completion of the PCI in department of cardiology of our hospital from February 2012 to December 2012. At the same time, selected randomly 60 cases of healthy subjects as normal control group who was hospitalized with coronary angiography did not see obvious anomalies. Selected 77 patients with merger type 2 diabetes mellitus(T2DM) from AMI group and the 77 patients with non-merge type 2 diabetes mellitus(NT2DM) as a subgroup. Serum was collected before surgery and 0 hour and 4 hours and 24 hours after surgery. Measured level of plasma apelin-13 by enzyme linked immunosorbent assay. Furtherly, made subanalysis for diabetic and non-diabetic patients with AMI(77 cases in each group). The two groups of patients were followed at six months after surgery for main adverse cardiovascular and cerebrovascular events(MACE). ResultsApelin level increased significantly compared with pre-operation in the postoperative 4h and 24 h groups. Compared with healthy controls, the patients’ level of plasma apelin of AMI group declined obviously pre-operation and at 0h, 4h, 24 h after surgery. There is not obvious discrepancy in apelin between T2 DM group and NT2 DM group. The plasma apelin level of post operation at 4h and 24 h was significantly lower in T2 DM group compared with NT2 DM group. For the postoperative month-6 follow-up, the group of T2 DM increased significantly compared with the group of NT2 DM. However, there is not obvious discrepancy with respect to MACE between both groups. ConclusionWith monitoring changes of plasma apelin express so as to provide reference for treatment and prognosis of patients, we can assess indirectly the AMI patients’ improvement of PCI postoperative myocardial blood supply, the recovery of damaged myocardium and coronary vascular endothelial repair and angiogenesis, etc. So we think apelin will become the important targets of treatment and test of cardiovascular disease in the future.