Plasma DPP4 activity is associated with no-reflow and major bleeding events in Chinese PCI-treated STEMI patients

Jing Wei Li, Yun Dai Chen, Wei Ren Chen, Jing Jing, Jie Liu, Yong Qiang Yang, Jing Wei Li, Yun Dai Chen, Wei Ren Chen, Jing Jing, Jie Liu, Yong Qiang Yang

Abstract

Dipeptidyl peptidase-4 (DPP4) is an important regulator of incretins and inflammation, and it is involved in the pathophysiological process of myocardial infarction (MI). This study investigated the role of plasma DPP4 activity (DPP4a) in patients with ST-segment elevation myocardial infarction (STEMI) who had undergone percutaneous coronary intervention (PCI). We recruited 747 consecutive PCI-treated STEMI patients from a tertiary referral center from January 2014 to October 2015. The outcomes of interest were the rates of no-reflow, in-hospital major adverse cardiac or cerebrovascular events (iMACCE), in-hospital complications (IHC) and in-hospital major bleeding. The DPP4a was lower in STEMI patients compared with the controls (p < 0.0001). Multivariate logistic-regression analyses (adjusted for confounding variables) showed that a 1 U/L increase in DPP4a was associated with an increased rate of no-reflow events (odds ratio [OR]: 1.07; 95% CI: 1.02-1.11; p < 0.01) and a decreased rate of major bleeding events (OR: 0.90; 95% CI: 0.82-0.98; p = 0.02). There were no associations between DPP4a and either iMACCE or IHC. In conclusions, high levels of DPP4a are independently associated with an increased rate of no-reflow events and a decreased rate of major bleeding events in PCT-treated STEMI patients.

Figures

Figure 1. Characteristics of DPP4a at baseline…
Figure 1. Characteristics of DPP4a at baseline in STEMI patients.
(A) DPP4a was normally distributed. (B) DPP4a was negatively associated with age. (C) DPP4a was lower in the STEMI group compared with the CP and UA control groups. ****p < 0.0001 CP, chest pains; DPP4, dipeptidyl peptidase-4; ns, non-significant; NSTEMI, non-ST-segment elevation myocardial infarction; STEMI, ST-segment elevation myocardial infarction; UA, unstable angina.

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