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. 2024 Sep 24;10(19):e38401.
doi: 10.1016/j.heliyon.2024.e38401. eCollection 2024 Oct 15.

Adenosine deaminase is a risk factor for mortality after discharge in patients with acute myocardial infarction: Long-term clinical follow-up

Xiaoli Zhu  1 , Yijun Chen  1 , Yangjun Cai  2 , Jinxi Hu  2
Affiliations

Adenosine deaminase is a risk factor for mortality after discharge in patients with acute myocardial infarction: Long-term clinical follow-up

Xiaoli Zhu et al. Heliyon. .

Abstract

Background: Variations in adenosine deaminase (ADA) activity have been detected in numerous cardiovascular diseases (CVDs), but there is limited research on its role in the prognosis of CVDs. In this study, we explored the role of ADA in the prognosis of patients with acute myocardial infarction (AMI).

Method: In this study, a total of 1,574 patients with a first diagnosis of acute myocardial infarction (AMI) were followed up for a median (interquartile range [IQR]) of 77.0 (50.0, 95.0) months after discharge. Cox proportional hazards regression models were used to identify factors that are substantially valuable for patient prognosis.

Results: During the follow-up period, the mortality rate of AMI was 12.5 %. The 3-year and 5-year overall survival (OS) rates of AMI patients were 93.8 % and 91.0 %, respectively. Multivariate Cox regression analysis revealed that serum ADA (hazard ratio [HR] = 1.166, 95 % confidence interval [CI]: 1.006-1.352) was an independent risk factor for 5-year OS after discharge in AMI patients. When serum ADA was assessed in quartiles, compared with the reference group (Quartile 1), the adjusted HR for death was 2.498 (95 % CI: 1.344-4.642) in Quartile 4 for 5-year OS and 2.508 (95 % CI: 1.145-5.496) in Quartile 4 for 3-year OS.

Conclusions: Serum ADA levels at admission are a risk factor that affects the long-term prognosis of AMI patients after hospital discharge.

Keywords: Acute myocardial infarction; Adenosine deaminase; All-cause mortality; Prognosis.

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Conflict of interest statement

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Included and excluded AMI patients.
Fig. 2
Fig. 2
Kaplan-Meier survival analysis of cumulative survival curves in this follow-up according to ADA quartile level. The AMI patients were divided into four quartiles according to serum ADA concentration: Q1: <7.0 U/L; Q2: 7.0–8.0 U/L; Q3: 8.1–10.0 U/L; Q4: >10.0 U/L. Abbreviations: Adenosine deaminase, ADA.
Fig. 3
Fig. 3
Restricted cubic spline fitting for the association between ADA level and HR of overall survival in the follow-up. The shaded area represents the 95 % CI. Abbreviations: Adenosine deaminase, ADA; Hazard ratio, HR.
Fig. 4
Fig. 4
Stratified analysis of HRs in 5-year overall survival follow-up of AMI patients. Abbreviations: Acute myocardial infarction, AMI; Adenosine deaminase, ADA; ST-segment elevation myocardial infarction, STEMI; Chronic obstructive pulmonary disease, COPD; Percutaneous coronary intervention, PCI; Angiotensin-converting enzyme inhibitors/Angiotensin receptor blockers, ACEI/ARB; Hazard ratio, HR.
See this image and copyright information in PMC

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