Adiponectin and ischemia-reperfusion injury in ST segment elevation myocardial infarction.
BACKGROUND
Models of experimental ischemia-reperfusion (IR) in adiponectin knockout animals have shown that adiponectin mediates protection against the development of IR injury. However, the role of adiponectin in IR injury in humans is largely unknown.


METHODS
In a total of 234 ST segment elevation myocardial infarction (STEMI) patients, baseline circulating total adiponectin concentration was correlated with IR injury after primary percutaneous coronary intervention (pPCI) and with major adverse cardiac events (MACE, death and cardiac hospitalization) during one year of follow up. IR injury was defined by serial electrocardiography (ECG) as >30% persistent ST segment elevation despite successful restoration of vessel patency and by angiography as thrombolysis in myocardial infarction (TIMI) blush grade<2.


RESULTS
IR injury was present in 31% of patients according to ECG criteria and in 28% of patients according to angiographic criteria. The median adiponectin level was 6.8 µg/ml in patients with ECG signs of IR injury and 6.5 µg/ml in patients without ECG signs of IR (p=0.26). When the angiographic criteria of IR were used, the median adiponectin level was 6.9 µg/ml for patients with IR versus 6.3 µg/ml for patients without IR (p=0.06). MACE occurred in 27% of the patients. Median adiponectin levels were similar in patients with MACE and in those without MACE: 6.3 vs. 6.4 µg/ml (p=0.24). In a multivariate model, no significant relation between circulating adiponectin levels and IR injury or MACE was evident.


CONCLUSIONS
In the current era of pPCI, IR injury still occurs in almost one third of STEMI patients. Our findings do not support a major protective role of adiponectin in the prevention or attenuation of IR injury in these patients.
Antwerp University Hospital, Department of Cardiology, Belgium.
Lynn
L
De Roeck
Antwerp University Hospital, Department of Cardiology, Belgium.
Sarah
S
Vandamme
Antwerp University Hospital, Department of Cardiology, Belgium.
Bert R
BR
Everaert
Laboratory of Cellular and Molecular Cardiology, University of Antwerp, Belgium.
Vicky
V
Hoymans
Antwerp University Hospital, Department of Cardiology, Belgium.
Steven
S
Haine
Antwerp University Hospital, Department of Cardiology, Belgium.
Tom
T
Vandendriessche
Antwerp University Hospital, Department of Cardiology, Belgium.
Johan
J
Bosmans
Antwerp University Hospital, Department of Cardiology, Belgium.
Mark W
MW
Ronsyn
Antwerp University Hospital, Department of Cardiology, Belgium.
Hielko
H
Miljoen
Antwerp University Hospital, Department of Cardiology, Belgium.
An
A
Van Berendoncks
Laboratory of Pharmacology, University of Antwerp, Belgium.
Guido
G
De Meyer
Antwerp University Hospital, Department of Cardiology, Belgium.
Christiaan
C
Vrints
Antwerp University Hospital, Department of Cardiology, Belgium marc.claeys@uantwerpen.be.
Marc J
MJ
Claeys
D052242:Adiponectin / Q000097:blood*; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000601:surgery*; D015425:Myocardial Reperfusion / Q000009:adverse effects / Q000379:methods*; D017063:Outcome Assessment, Health Care; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015427:Reperfusion Injury / Q000097:blood* / Q000517:prevention & control
D052242:Adiponectin
Adiponectin; myocardial infarction; reperfusion injury