Value of blood adipose tissue hormones concentration--adiponectin, resistin and leptin in the prediction of major adverse cardiac events (MACE) in 1-year follow-up after primary percutaneous coronary intervention in ST-segment elevation acute myocardial i

OBJECTIVES: The objective of the study was to assess the impact of adipokines on the future major adverse cardiac events (MACE) in patients with acute myocardial infarction.

METHODS: Subjects were 77 men with first, ST-segment elevation acute myocardial infarction undergoing primary percutaneous coronary intervention in whom data were available after one year follow-up. Baseline clinical and angiographic data were collected, blood level of C-reactive protein, uric acid, fasting glucose, lipid profile, adiponectin, resistin and leptin and left ventricular ejection fraction on echocardiography were assessed. MACE was defined as cardiac death, nonfatal myocardial infarction, hospitalization for angina or heart failure.

RESULTS: 12% of patients experienced MACE. As revealed by univariate logistic regression analysis predictors of MACE were diabetes, multivessel disease, ejection fraction, blood C-reactive protein and adiponectin level. In multivariable analysis diabetes (OR=22.19, 95%CI 1.22-402.19; p=0.0360), lower left ventricular ejection fraction (OR=0.78, 95%CI 0.63-0.98; p=0.0298) and lower adiponectin level (OR=0.19, 95%CI 0.04-0.90; p=0.0362) were independent negative predictors of MACE. The optimal value of adiponectin for predicting MACE was 4.23 microg/ml. CONCLUSION. In male patients with myocardial infarction undergoing primary percutaneous coronary intervention, a baseline blood adiponectin but not resistin or leptin is independently predictive of MACE. The other prognostic factors are diabetes mellitus and left ventricular ejection fraction.