The Serum Adropin And Adipnectin Levels In Patients With Acute Myocardial Infarction And Its Clinical Significance

Objective: To investigate the predictive value of adropin and adipnectin in patients with STEMI.To investigate the association between levels of adropin and adipnectin and coronary lesion complexity and myocardial infarction degree in patients with STEMI.To investigate the association between levels of adropin and adipnectin and myocardial perfusion after percutaneous coronary intervention(PCI) in patients with STEMI.To investigate the predictive value of adropin and adipnectin for patients with STEMI in MACE.Methods: Forward-looking selected patients with acute ST segment elevation myocardial infarction, set up stable angina and the negative control group. All patients were taken blood samples before coronary angiography. Serum adropin and adipnectin were measured by enzyme-linked immunosorbent assay(ELISA). All patients underwent coronary angiography,with a diameter determined the extent of coronary artery stenosis,with the Gensini scoring system to rate. All the pantiens with STEMI were recorded the preoperative and postoperative 1 hour electrocardiogram(ECG) and calculated the rate of ST segment fell back. To patients with STEMI, recording TIMI flow classification after percutaneous coronary intervention. Monitoring dynamically the levels of troponin T(c Tn T), recording a peak, and using the troponin T levels as the degree of myocardial injury. In the hospitalization period, the major adverse cardiac events(MACE) were recorded in patients with STEMI, including cardiac death, and recurrence of nonfatal myocardial infarction, and target vessel reascularization, new atrial fibrillation and stroke.Results: 108 Cases of patients with acute STEMI were selected, including 89 cases of male and 19 cases of female,and their age is between 30 to 86. Stable angina group is37 cases and the negative control group is 19 cases. All patients underwent coronary angiography.The results indicatd:1. Adropin levels in patients with STEMI are lower significantly than the control group(160.53±32.20 vs 209.61±27.11Pg/ml, P<0.001). STEMI group have no significant difference With SA group(160.53±32.20 vs 165.59±30.55 pg/ml, P=0.397); Adiponectin levels in patients with STEMI are lower significantly than SA group(1413.94±218.83 vs1513.08±210.49 pg/ml, P=0.017).Adiponectin levels in patients with SA are lower significantly than the negative control group(1513.08±210.49 vs 1756.34±205.54pg/ml,P<0.001).2. Multiariable Logistic regression analysis shows that low levels of serum adropin(AOR=0.983 95%CI=0.971~0.995,P=0.007)and lower levels of serum adiponectin(OR= 0.996, 95%CI = 0.994 ~ 0.998, P <0.001)are an independent predictor of patients with STEMI in CHD patients.3. Adropin levels in patients with STEMI EF > 50% group is obviously higher than that of EF < 50% group(166.99 ±30.43 vs 144.41 ± 31.23 pg/ml, P = 0.001).Adiponectin levels in patients with STEMI EF > 50% group is obviously higher than that of EF < 50% group(1452.97 ± 213.84 vs 1310.74 ±202.12 pg/ml,P = 0.002).4. Adropin level with ST segment fell back rate > 70% is higher than that of ST segment fell back rate < 70% group(173.56 ± 30.13 vs 155.72 ± 31.77 pg/ml, P =0.01).Adiponectin level with ST segment fell back rate > 70% is higher than that of ST segment fell back rate < 70% group(1488.51±205.45 vs 1384.11±218.82 pg/ml, P =0.028).To patients after percutaneous coronary intervention with STEMI, serum Adropin level no obvious difference between TIMI 3 group and TIMI 0~2 group(163.39±31.58 vs151.22±33.73pg/ml, P=0.123), and diponectin level no obvious difference between TIMI 3group and TIMI 0~2 group(1430.65±218.54 vs 1350.71±214.97pg/ml,P=0.112).5. Adropin levels in patients with AMI have no obvious correlation with the highest c Tn T(R = 0.129, P = 0.248). Adiponectin levels in patients with AMI have no obvious correlation the highest c Tn T(R = 0.176, P = 0.115).6. Adropin levels in patients with STEMI have no obvious correlation with Gensini score(R=0.004, P = 0.964).Adiponectin levels in patients with STEMI have no obvious correlation with Gensini score(R =-0.05, P = 0.956).7. Patients with STEMI were in hospital on average(8.1±3.6)day, and 8 cases happened MACE, including 2 cases of cardiac death, 6 cases of patients with new atrialfibrillation. Adropin levels in patients with the MACE have no significant difference with that of the patients without the MACE(159.3 ± 32.1 vs. 175.3 ± 32.2 pg/ml, P = 0.178),adiponectin levels in patients with the MACE have no significant difference with that of the patients without the MACE(1411.39± 221.17 vs. 1445.87 ± 197.25 pg/ml, P =0.649).Multiariable logistic regression do not show that adropin and adiponectin levels have association with MACE.Conclusions1. Lower serum levels of adropin and adiponectin were the significant independent predictor of STEMI in CHD patients.2. To patients with STEMI and lower serum levels of adropin and adiponectin after percutaneous coronary intervention, the rate of ST segment fell back is low, and EF values is low.3.Serum adropin and adiponectin levels have nothing to do with the highest c Tn T in patients with STEMI,which shows they have nothing to do with the degree of myocardial damage.4.adropin and adiponectin levels have no association with MACE to patients with STEMI in the hospital.