The value of apelin-36 and brain natriuretic peptide measurements in patients with first ST-elevation myocardial infarction.
BACKGROUND
We aimed to assess apelin-novel endogenous ligand for the angiotensin-like 1 receptor in patients with ST-elevation myocardial infarction (STEMI) and to compare its value with B-type natriuretic peptide (BNP).


METHODS
In 78 consecutive patients with first STEMI treated with primary PCI, plasma apelin-36 (RIA) and BNP (MEIA) concentrations were measured twice: on admission and on the fifth day of hospitalization. Left ventricle ejection fraction (LVEF) was assessed on admission and composite endpoint (CEP)-after 1 year follow-up.


RESULTS
During the 5-day interval median plasma BNP level significantly increased and median plasma apelin concentration significantly decreased. BNP, but not apelin, correlated with low LVEF (<50%). In ROC analysis only BNP measurements were diagnostic for low LVEF. In ANOVA test, in patients with CEP, a significant decrease in apelin (but not BNP) concentrations measured in 5-day interval was found. ROC analysis identified only second BNP measurement as significant to estimate adverse outcome 0.627 in the prediction of CEP (95% confidence interval=0.507-0.736).


CONCLUSIONS
Following STEMI there is a decrease of plasma apelin-36 concentration and an increase of plasma BNP concentration. BNP is better, than apelin diagnostic value for the detection of impaired LVEF. Both BNP and apelin have prognostic value, although both needs further evaluation.
Tycinska
Agnieszka M
AM
Department of Cardiology, Medical University, Bialystok, Poland. agnieszka.tycinska@gmail.com
Sobkowicz
Bozena
B
Mroczko
Barbara
B
Sawicki
Robert
R
Musial
Wlodzimierz J
WJ
Dobrzycki
Slawomir
S
Waszkiewicz
Ewa
E
Knapp
Malgorzata A
MA
Szmitkowski
Maciej
M
D000368:Aged; D000073861:Apelin; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000378:metabolism* / Q000628:therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000378:metabolism
C115436:APLN protein, human; D000073861:Apelin; D036341:Intercellular Signaling Peptides and Proteins; D020097:Natriuretic Peptide, Brain