Abstract
Plasma dipeptidyl-peptidase-4 activity (DPP4a) is inversely associated with left ventricular function in patients with heart failure (HF) or diabetes. However, the association between DPP4a and left ventricular function in ST-segment elevation myocardial infarction (STEMI) patients has not been reported. We studied this association in 584 consecutive STEMI patients at a tertiary referral center from July 2014 to October 2015. DPP4a and plasma N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels were quantified by enzymatic assays. The median serum NT-proBNP levels were highest in patients of the lowest tertile (T1) of DPP4a compared with that of the highest tertile (T3) (p = 0.028). The STEMI patients in T1 exhibited lower left ventricular systolic function (T1 vs. T3: left ventricular ejection fraction (LVEF): 50.13 ± 9.12 vs. 52.85 ± 6.82%, p = 0.001). Multivariate logistic-regression analyses (adjusted for confounding variables) showed that a 1 U/L increase in DPP4a was associated with a decreased incidence of left ventricular systolic dysfunction (LVSD) (adjusted odds ratio: 0.90; 95% CI: 0.87–0.94; p < 0.01). In conclusion, low DPP4a is independently associated with LVSD in STEMI patients, which suggests that DPP4 may be involved in the mechanisms of LVSD in STEMI patients.
Highlights
Left ventricular systolic dysfunction (LVSD), whose representative indicator is left ventricular ejection fraction (LVEF), is an important marker of poorer prognosis in patients after an acute myocardial infarction (AMI), for both in-hospital and long-term follow-up[1, 2]
We found that elevated DPP4 activity (DPP4a) is associated with no-reflow phenomenon and a decreased rate of major bleeding events in ST-segment elevation myocardial infarction (STEMI) patients treated with percutaneous coronary interventions (PCI)[11]
We found that elevated DPP4a levels in STEMI patients were associated with lower peak NT-proBNP levels, with better LV systolic function and lower rates of left ventricular systolic dysfunction (LVSD) independent of confounding factors
Summary
Left ventricular systolic dysfunction (LVSD), whose representative indicator is left ventricular ejection fraction (LVEF), is an important marker of poorer prognosis in patients after an acute myocardial infarction (AMI), for both in-hospital and long-term follow-up[1, 2]. Soluble DPP4 circulating in the plasma exerts catalytic activity cleaving oxyntomodulin[6] and SDF-17, as does membrane-type DPP4. We found that plasma DPP4 activity (DPP4a) is decreased in patients with MI compared with those with only chest pain or unstable angina pectoris. We found that elevated DPP4a is associated with no-reflow phenomenon and a decreased rate of major bleeding events in ST-segment elevation myocardial infarction (STEMI) patients treated with percutaneous coronary interventions (PCI)[11]. The relationship between DPP4a and left ventricular function in patients with STEMI has not been reported. Evaluate the relationship between DPP4a levels on admission in STEMI patients treated with PCI, and their left ventricular (LV) function, as assessed by echocardiography during the first 3 days of hospitalization
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