Correlation Between Serum Visfatin And Cardiovascular Events In Patients With Acute Myocardial Infarction

Objective:To observe serum visfatin levels in acute myocardial infarction(AMI)patients and explore the relationship between serum visfatin levels and the indicators of acute myocardial infarction,echocardiogram parameters,and the number of coronary artery lesions.To observe the correlation between serum visfatin levels and the occurrence of major adverse cardiovascular events.Method:Total 183 patients with AMI were in the department of cardiology in our Hospital from January 2016 to September 2016.The indices including gender,age,body mass index,past medical history,laboratory examination results and echocardiogram results were recorded.The control group included 55 subjects who in the department of cardiology of our Hospital in the same period were as the control group.All of control group has taken coronary angiography examination,with coronary artery stenosis less than 50%,gender and age were match to the experimental group.Serum visfatin levels in AMI patients and controls were detected by enzyme-linked immunosorbent assay.Patients with AMI were followed up for 16-24 months.The observation endpoints were the occurrence of major adverse cardiovascular events(MACEs),including severe angina,non-fatal re-MI,heart failure,arrhythmias and death of cardiovascular events.Independent-samples T test was used for normal distribution of data,Rank sum test was used for non-normall distribution of data,Chi-square test was used for contrast of count data,Logistic analysis was used to analyze the independent risk factors of MACEs,ROC curve was used to predict the MACEs,Kaplan-meier analysis was conducted to evaluate the survival of patients.Result:1.Serum visfatin levels in AMI patients was 7.702(6.573,9.823)ng/ml,significantly higher than control group 6.74(5.76,7.53)ng/ml(p<0.05).Serum visfatin levels were elevated with the number of coronary artery lesions,however,there were no statistically significant difference between the groups(p>0.05).Multivariate linear regression analysis showed that after adjusting for gender and age,serum visfatin levels correlated positively with Apo A,FIB,AMI history and negatively with BMI,TG,HDL-C.2.Total 183 patients with AMI were enrolled and followed up(average 19.3 months),24 cases were excluded because of various reasons,and only 159 patients received follow-up.18(11.32%)patients presented with MACEs.Of these,7(4.40%)suffered non-fatal re-MI,2(1.26%)suffered heart failure,9(5.65%)died.Total 159 patients with AMI were divided into MACEs group and non-MACEs group,we found that MACEs group had significantly higher age,diabetes,Cr,NT-proBNP,serum visfatin levels(all p<0.05)and lower ALB,TC,TG,LVEF(all p<0.05)compared with non-MACEs group.3.Binary logistic analysis showed that after adjusting for gender and age,serum visfatin levels(OR=1.278,p=0.021)、TC(OR=0.028,p=0.017)、LDL-C(OR=2.990,p=0.041)and diabetes(OR=3.766,p=0.041)were independent risk factor for the occurrence of MACEs.4.A combined model consisting of serum visfatin levels and traditional risk factors(smoking,hypertension,diabetes,hyperlipidemia,BMI)showed a 0.783 area under curve(AUC)with a 72.2%sensitivity and 73.8%specificity.Through receiver operating characteristic curve,we found that serum visfatin levels of 8.799ng/ml was the highest sensitivity and specificity associated with MACEs.Patients were divided into two groups based on the threshold of serum visfatin.By chi-square test,we found that the occurrence of MACEs were elevated in the high serum visfatin levels group(serum visfatin levels more than 8.799 ng/ml)compared to the low serum visfatin levels group(serum visfatin levels less than 8.799ng/ml),and the occurrence of non-fatal re-MI were elevated in the high serum visfatin levels group(p=0.049).5.The multivariate Cox proportional hazards regression analysis found that after adjusting for gender and age,the serum visfatin levels(HR=1.214,95%CI 1.004-1.468,p=0.045)and DDimer(HR=1.561,95%CI 1.062-2.296,p=0.024)were the independent risk factors for the occurrence of MACEs.The Kaplan-meier analysis demonstrated that the time of the occurrence of MACEs were ahead in the high serum visfatin levels group compared to the low serum visfatin levels group,and the cumulative survival time were shorted(p=0.004).Conclusion:1.Serum visfatin levels were elevated in the AMI patients compared to control(p<0.05),and were elevated with the number of coronary artery lesions.2.Visfatin were independent risk factor for the occurrence of MACEs.A combined model consisting of visfatin and traditional risk factors showed a higher sensitivity and specificity in predictive the occurrence of MAGEs.3.The occurrence of MACEs were ahead in the high serum visfatin levels group compared to the low serum visfatin levels group,and the cumulative survival time were shorted.