Association between Apelin-36 and Gensini score depending on the no-reflow phenomenon in STEMI patients

Background Apelin is a novel adipocytokine with a significant role in myocardial ischemia-reperfusion injury. Apelin is synthesized in cardiomyocytes and resides in heart tissue and circulatory system. Purpose To evaluate association between apelin-36 and Gensini score in STEMI patients depending on reperfusion injury. Methods In this study we included one hundred and sixty-one patients with following criteria: a) detection of cardiac biomarkers (car-diac troponin (cTn)) (ESC 0h/1h and 0h/2h algorithms), b) symptoms of ischemia, and c) ECG changes including new ST elevation at the J-point in at least two contiguous leads (≥2.5mm in men <40 years, ≥2mm in men ≥40 years, or ≥1.5mm in women re-gardless of age in leads V2-V3 or ≥1mm in the other leads). All patients underwent revascularization with primary percutaneous coronary intervention (PCI) within period of 12h. The levels of apelin-36, creatine kinase (CK), the MB fraction of creatine kinase (CKMB), troponin I, creatinine, hemoglobin, and other routine laboratory parameters were measured. Results In patients with TIMI flow ≤2 the mean value of apelin-36 level was 0.80± 0.66, and with TIMI flow 3, it was 0.50 ± 0.51. Variability was observed in the apelin-36 values (Kruskal-Wallis test) based on TIMI flow grade (p<0.001), and in the Gensini score (p<0.001) (Table 1). The degree of association between apelin-36 and Gensini score was analyzed with Spearman’s correlation resulting in patients without reperfusion injury (TIMI flow 3) p=0.23 while in those with reperfusion injury (TIMI flow ≤2) p= 0.002. Figure 1 shows the association of apelin-36 and Gensini score in patients with TIMI flow grade 3, while Figure 2 this association shows in patients with TIMI flow grade ≤2. Conclusions Apelin-36 levels positively correlated with Gensini score depending reperfusion injury. This confirms the predictive value of Apelin-36 for reperfusion injury in STEMI patients who underwent pPCI.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.