CARDIOVASCULAR JOURNAL OF AFRICA • Volume 35, No 1, January – April 2024 36 AFRICA kinase, protecting the myocardium from ischaemia–reperfusion injury.26-28 The aim of this study was to evaluate the association of apelin-12 and CK-MB levels to predict the effectiveness of reperfusion therapy in ST-elevation myocardial infarction (STEMI) patients. Methods This prospective, observational study included 72 patients with STEMI. Inclusion criteria were: chest pain suggestive of myocardial ischaemia for at least 30minutes, an electrocardiogram (ECG) with ST-segment elevation, measured at the J-point, ≥ 2 mm in leads V2–V3 and/or ≥ 1 mm in the other leads, increased specific biomarkers [cardiac troponin (cTn) and CK-MB], and patients who underwent reperfusion therapy. All patients received aspirin 250 to 500 mg, clopidogrel 300 to 600mg andheparin 4 000 to 5 000 IUbefore primary percutaneous coronary intervention (PCI). The use of glycoprotein IIb/IIIa inhibitors or vasodilators in the catheterisation laboratory was left to the decision of the treating cardiologist. Based on coronarography, coronary perfusion was determined according to the thrombolysis in myocardial infarction (TIMI) flow grade, with a grade 3 blood flow indicating normal flow and a grade 0 indicating no flow within the vessel. The PCI procedure was performed using standard methods and success was determined by the TIMI grade flow. Unsuccessful myocardial reperfusion was defined by a 12-lead ECG one hour after successful recanalisation of the infarcted artery as > 30% persistent ST-segment elevation and by coronarography as TIMI grade ≤ 2. Transthoracic echocardiography was performed for assessment of left ventricular ejection fraction. Baseline and procedural characteristics of all STEMI patients were documented upon admission and included age, gender, coronary risk factors (diabetes mellitus, dyslipidaemia, hypertension and smoking), family history of cardiovascular disease, previous medications and time from onset to admission. Routine laboratory parameters were measured at admission. Blood samples for measurement of apelin-12 and CK-MB levels were collected 12 hours after reperfusion therapy. The serum was obtained by allowing the blood to solidify in a serum tube for 30 minutes, centrifuged for 15 minutes at 1 600 rpm, and stored at –80°C to prevent degradation. According to the manufacturer’s instructions, apelin-12 was measured with enzyme-linked immunosorbent assay (ELISA), and CK-MB was measured with the immunological inhibition method. The institutional ethics committee of Dubrava University Hospital, Zagreb and the University Clinical Centre of Kosova, Pristina approved this study. Informed consent was obtained from all individuals participating in the study. Statistical analysis The main objective of the study was to investigate the association of apelin-12 level with CK-MB activity according to the success of reperfusion in patients with STEMI. Mean ± standard deviation (SD) and median (range) are used to present continuous variables, while categorical variables are expressed as counts and percentages. Comparison of laboratory variables between patients with different TIMI flows (TIMI flow ≤ 2 or 3) was performed using the Mann– Whitney test. The association between variables was assessed with Pearson’s correlation. Statistical analyses were performed using SPSS statistics v 21. Sarcolema T-tubule Mitocho ATP synt ATP ase ATP ase G-protein CK CK CK ADP ADP ADP ADP A D P A D P M PCr Cr PLC PKC APJ Apelin SERCA Fig. 1. Relationship between apelin-12 levels and CK-MB activity.
RkJQdWJsaXNoZXIy NDIzNzc=