IRISIN IN PREDICTING MAJOR ADVERSE CARDIAC EVENTS AFTER MYOCARDIAL INFARCTION IN OBESE HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS

Abstract

Objective: Cardiovascular diseases (CVDs), particularly ST-elevation myocardial infarction (STEMI), remain the leading causes of mortality and disability worldwide. This study aimed to evaluate the relationship between serum irisin levels and the development of major adverse cardiovascular events (MACE) in high-risk patients with hypertension, type 2 diabetes mellitus (T2DM), and obesity following STEMI. Material and Methods: A prospective observational study included 238 hypertensive patients with T2DM and obesity (BMI>30 kg/m²) admitted with a first STEMI. Patients were divided into MACE (n=117) and non-MACE (n=121) groups. Serum irisin was measured by ELISA. MACE was assessed over 12 months and included recurrent myocardial infarction, stroke, cardiovascular death, and hospitalisation for heart failure. Results: Irisin levels were significantly lower in the MACE group (121.57±15.86 ng/mL) than in the non-MACE group (129.31±17.93 ng/ mL; p=0.0005). Patients with MACE had a significantly longer duration of hypertension and T2DM. A non-dipper blood pressure profile was more frequent in the MACE group (41.88% vs. 26.44%; p=0.0121). Multivariate logistic regression revealed that lower irisin levels (OR: 0.911; 95% CI: 0.417–0.991; p=0.041) and non-dipper BP profile were independent predictors of MACE. Conclusion: Lower irisin levels and abnormal circadian BP rhythm are associated with increased MACE risk after STEMI in patients with T2DM and obesity. Irisin may serve as a valuable biomarker for early risk stratification in such high-risk populations.

Keywords

• Irisin
• myocardial infarction
• hypertension
• obesity
• dia betes mellitus

İRİSİNİN, OBEZ HİPERTANSİF TİP 2 DİYABET HASTALARINDA MİYOKARD ENFARKTÜSÜNDEN SONRA MAJÖR KARDİYAK ADVERS OLAYLARI ÖNGÖRMEDEKİ ROLÜ

Abstract

Amaç: Kardiyovasküler hastalıklar (KVH), özellikle ST-yükselmeli miyokard enfarktüsü (STEMI), dünya çapında ölüm ve sakatlıkların önde gelen nedeni olmaya devam etmektedir. Bu çalışma, STEMI sonrası hipertansiyon, tip 2 diabetes mellitus (T2DM) ve obezitesi olan yüksek riskli hastalarda serum irisin seviyeleri ile majör advers kardiyovasküler olayların (MACE) gelişimi arasındaki ilişkiyi değerlendirmeyi amaçlamaktadır. Gereç ve Yöntemler: Prospektif gözlemsel bu çalışmaya, ilk STEMI ile başvuran T2DM ve obezitesi (VKİ>30kg/m²) olan 238 hipertansif hasta dahil edildi. Hastalar MACE (n=117) ve MACE olmayan (n=121) gruplara ayrıldı. Serum irisin düzeyleri ELISA ile ölçüldü. MACE 12 ay boyunca tekrarlayan miyokard enfarktüsü, inme, kardiyovasküler ölüm ve kalp yetmezliği nedeniyle hastaneye yatışı kapsayan bir değerlendirme yapıldı. Bulgular: İrisin düzeyleri MACE grubunda (121,57±15,86 ng/mL), MACE olmayan gruba (129,31±17,93 ng/mL; p=0,0005) kıyasla anlamlı derecede düşüktü. MACE hastalarında hipertansiyon ve T2DM süresi anlamlı derecede daha uzundu. Non-dipper kan basıncı profili MACE grubunda daha sıktı (%41,88'e karşı %26,44; p=0,0121). Çok değişkenli lojistik regresyon, düşük irisin düzeylerinin (OR: 0,911; %95 GA: 0,417-0,991; p=0,041) ve non-dipper kan basıncı profilinin MACE'nin bağımsız öngörücüleri olduğunu ortaya koydu. Sonuç: Düşük irisin düzeyleri ve anormal sirkadiyen kan basıncı ritmi, T2DM ve obezitesi olan hastalarda STEMI sonrası artmış MACE riski ile ilişkilidir. İrisin, bu tür yüksek riskli popülasyonlarda erken risk sınıflandırması için değerli bir biyobelirteç olarak görev alacağı öngörülmektedir.

Keywords

• İrisin
• miyokard enfarktüsü
• hipertansiyon
• obezite
• diyabet mellitus

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