ORIGINAL ARTICLE   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2019 October;178(10):815-20

DOI: 10.23736/S0393-3660.18.03970-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Relation of serum adiponectin levels and glycated hemoglobin to major adverse cardiac events in prediabetic patients after ST-segment elevation myocardial infarction

Blerim BERISHA ✉, Xhevdet KRASNIQI, Masar GASHI, Josip VINCELJ

Clinic of Cardiology, University Clinical Center of Kosovo, Prishtinë, Kosovo

BACKGROUND: Microvascular dysfunction and glucometabolic dysregulation are associated with poor prognosis after acute myocardial infarction. It has been reported that adiponectin modulates vascular homeostasis and protects against cardiometabolic disorders. This study aimed to investigate the association of adiponectin and HbA1C with major adverse cardiac events in non-diabetic patients who survived STEMI.
METHODS: The study prospectively enrolled 73 non-diabetic white patients who experienced STEMI infarction. The subjects were divided into two groups: 37 patients with elevated glycated haemoglobin (group 1) and 36 patients with normal levels of glycated hemoglobin (group 2). In a one-year follow-up, the study subjects were observed for major adverse cardiac events (MACE).
RESULTS: Adiponectin correlated inversely with HbA1C and BMI in all study subjects (P<0.001, P<0.01). Univariate and multivariate logistic regression analysis revealed that MACE was significantly associated with adiponectin (P=0.018, P=0.011). Mean adiponectin levels were significantly lower in group 1 (1.59±1.56 ng/mL) than in group 2 (2.98±2.32 ng/mL) (P=0.004). HDL, and CRP levels were also significantly different between groups (P=0.004, P=0.038). The frequency of MACE was significantly higher in group 1 than in group 2 (43.2% vs. 22%, P=0.048).
CONCLUSIONS: Adiponectin correlated inversely with HbA1C and BMI and was associated with major adverse cardiac events after STEMI. A low level of adiponectin after acute coronary syndrome may lead to hyperglycemia; however, patients with an HbA1C>6% were at particularly high risk for MACE and should be considered for prevention interventions.

KEY WORDS: Adiponectin; Glycated hemoglobin A; Risk management