Key result
In patients with STEMI, apelin-12 levels >2.2 ng/mL on the seventh day were associated with a significantly lower rate of major adverse cardiac events over 12 months.
Observational (n=100)
Yes
Effect estimate: AUC 0.71 (95% CI 0.58-0.84)
p-value: p=0.004
In STEMI patients, apelin-12 levels are inversely correlated with troponin I in the acute phase, and low apelin levels on day 7 are predictive of a higher rate of MACE at 12 months.
Apelin-12 on day 7 may aid STEMI risk stratification; leaves open its incremental value and requires prospective validation.
BACKGROUND: levels activates protease I (caplain I), leading to the proteolytic degradation of troponins. Concurrently, the levels of apelin and APJ expression are increased by limiting myocardial injury. METHODS: In this prospective observational study, 100 consecutive patients with ST-elevation acute myocardial infarction were included. Patients meeting the following criteria were included in our study: (1) continuous chest pain lasting for >30 min, (2) observation of ST-segment elevation of more than 2 mm in two adjacent leads by electrocardiography (ECG), (3) increased cardiac troponin I levels, and (4) patients who underwent reperfusion therapy. We evaluated the levels of apelin-12 and troponin I on the first and seventh days after reperfusion therapy in all patients. RESULTS: 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 area under the curve (p = 0.004). CONCLUSION: The influence of apelin levels on troponin levels in the acute phase of STEMI is inversely correlated, whereas in the non-acute phase, low apelin values were associated with a high rate of MACE.
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Krasniqi et al. (2017) conducted an observational in ST-elevation acute myocardial infarction (STEMI) (n=100). Apelin-12 levels vs. Low apelin-12 levels (≤2.2 ng/mL) was evaluated on Association of apelin-12 levels on the seventh day with major adverse cardiac events (MACE) (AUC 0.71, 95% CI 0.58-0.84, p=0.004). In patients with STEMI, apelin-12 levels >2.2 ng/mL on the seventh day were associated with a significantly lower rate of major adverse cardiac events over 12 months.
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