Significant Association of Serum Adiponectin and Creatine Kinase-MB Levels in ST-Segment Elevation Myocardial Infarction

Abstract

Aims: Adiponectin, an adipocyte-specific secretory protein, abundantly exists in the blood stream while its concentration paradoxically decreases in obesity. Hypoadiponectinemia is one of risks of cardiovascular diseases. However, impact of serum adiponectin concentration on acute ischemic myocardial damages has not been fully clarified. The present study investigated the association of serum adiponectin and creatine kinase (CK)-MB levels in subjects with ST-segment elevation myocardial infarction (STEMI).

Methods: This study is a physician-initiated observational study and is also registered with the University Hospital Medical Information Network (Number: UMIN 000014418). Patients were admitted to Senri Critical Care Medical Center, given a diagnosis of STEMI, and treated by primary percutaneous coronary intervention (PCI). Finally, 49 patients were enrolled and the association of serum adiponectin, CK-MB, and clinical features were mainly analyzed.

Results: Serum adiponectin levels decreased rapidly and reached the bottom at 24 hours after recanalization. Such reduction of serum adiponectin was inversely correlated with the area under the curve (AUC) of serum CK-MB (p=0.013). Serum adiponectin concentrations were inversely correlated with AUC of serum CK-MB. In multivariate analysis, serum adiponectin concentration on admission (p=0.002) and collateral (p=0.037) were significantly and independently correlated with serum AUC of CK-MB.

Conclusion: Serum AUC of CK-MB in STEMI subjects was significantly associated with serum adiponectin concentration on admission and reduction of serum adiponectin levels from baseline to bottom. The present study may provide a possibility that serum adiponectin levels at acute phase are useful in the prediction for prognosis after PCI-treated STEMI subjects.

Keywords: Acute coronary syndrome; Adiponectin; CK-MB; Infarct size; Myocardial infarction.

Fig. 1.

Change of serum adiponectin levels. Serum adiponectin concentration on admission was set at 100%. Curve shows the connected median, box shows the interquartile range, bar shows the 10th to 90th percentile of 49 patients. *p < 0.001, **p < 0.0001, compared with the 100% on admission

Fig. 2.

Correlations between serum adiponectin concentration and AUC of CK-MB. Serum adiponectin concentrations were shown in the horizontal axis, on admission (A), at 24 hours (B), at 168 hours (C), and at minimum value (D). CK-MB, MB fraction of creatine kinase; AUC, area under the curve

Fig. 3.

Impact of serum adiponectin on AUC of CK-MB. A: Correlation between the reduction of serum adiponectin and serum AUC of CK-MB. Δ Serum adiponectin indicates the difference from baseline (on admission) to the minimum value of serum adiponectin (Min-adiponectin); Δ Serum adiponectin = (Min-adiponectin)−(baseline adiponectin). B: Serum AUC of CK-MB levels in quartile groups of serum adiponectin level on admission. Subjects were divided into 4 groups in proportion to serum adiponectin level at baseline (Q1, 1.6–3.1 µg/mL; Q2, 4.3–6.1 µg/mL; Q3, 6.2–8.6 µg/mL; Q4, 9.2–26.5 µg/mL). Shown are median values. Q1: minimum to the end of first quartile, Q2: the second quartile, Q3: the third quartile, Q4: the third quartile to maximum. CK-MB, MB fraction of creatine kinase; AUC, area under the curve