Serum Vaspin As a Predictor of Adverse Cardiac Events in Acute Myocardial Infarction

Background The involvement of vaspin (visceral adipose tissue-derived serpin) in the development of atherosclerotic cardiovascular diseases has been documented. This study was designed to explore the prognostic value of serum vaspin in patients with acute myocardial infarction ( AMI ). Methods and Results We included 1036 AMI patients in a cohort study and determined the association between serum vaspin and major adverse cardiac events ( MACE ) using Cox regression analysis. The receiver operating characteristic curve indicated that serum vaspin could significantly differentiate patients with MACE , and the optimal cutoff value was 0.62 ng/mL. The Kaplan-Meier survival curve showed that patients with lower vaspin levels had higher incidence of MACE . Multivariate Cox regression analysis revealed that low vaspin was an independent predictor of MACE (hazard ratio: 0.74; 95% CI , 0.48-0.96; P=0.029), together with age; previous histories of AMI , heart failure, hypertension, and diabetes mellitus; Killip class; revascularization; CRP (C-reactive protein); and NT-proBNP (N-terminal pro-B-type natriuretic peptide). Integrated discrimination and net reclassification improvements for MACE were significantly improved by addition of vaspin to the model of traditional risk factors. Moreover, low vaspin was a valuable predictor of heart failure hospitalization (hazard ratio: 0.58; 95% CI , 0.37-0.89; P=0.005) and recurrent AMI (hazard ratio: 0.72; 95% CI , 0.53-0.95; P=0.036) after adjustment for conventional cardiovascular risk factors. Conclusions Our study suggests that serum vaspin is a significant prognostic marker of MACE in AMI patients.