Serum Apelin Level Predicts the Major Adverse Cardiac Events in Patients With ST Elevation Myocardial Infarction Receiving Percutaneous Coronary Intervention

The cardiovascular profile of the apelin makes it a promising therapeutic target for heart failure and ischemic heart disease. However, it remains unknown whether apelin affect the clinical outcome of patients with ST elevation myocardial infarction (STEMI) and received percutaneous coronary intervention (PCI). We enrolled a total of 120 patients with acute STEMI who underwent primary PCI. Serum apelin was detected. After PCI procedure, all patients were followed for 12 months. The follow-up end-point was occurrence of major adverse cardiovascular event (MACE). Lower serum apelin levels (<0.54 ng/mL) was significantly associated with higher serum low density lipoprotein-cholesterol level, higher peak creatine kinase MB fraction (CK-MB) and peak troponin-I (TNI) levels, the number of obstructed vessels, and need for inotropic support. The incidence of MACE was significantly higher in the low apelin group (23 patients out of 67) than in the high apelin group (10 patients out of 75, P < 0.001). Kaplan-Meier analysis revealed that the MACE-free rate was significantly lower in the patients with low apelin than those with high apelin (P < 0.001, log rank test). The multivariate Cox proportional hazard analysis adjusted with the clinical and angiographic characteristic reveals that the serum low apelin is a predictor for MACE incidence (hazard ratio = 2.36, 95% confidence interval: 1.83-3.87, P = 0.004). The finding of this study suggests that the serum apelin may be used as a marker to predict the MACE after PCI in patients with STEMI.