Correlation Between Dipeptidyl Peptidase-4 Activity With Endothelial Dysfunction And The Complexity Of Coronary Artery Lesion In Patients With Acute Myocardial Infarction

Abstract

Background: Cardiovascular disease is the most cause of mortality and morbidity around the globe. Recent study shows that Dipeptidyl-peptidase-4 (DPP-4) play roles in regulating the inflammation and metabolism process, as well as involved in the development of endothelial dysfunction and atherosclerotic disease.

Objective: This study aims to find the correlation between the activity of DPP-4 with endothelial dysfunction measured by Flow Mediated Dilatation (FMD) and the complexity of coronary artery lesion assessed by SYNTAX score I in patients with acute myocardial infarction.

Method: A cross-sectional study was conducted in December 2019 – January 2020 in patients with acute myocardial infarction admitted and hospitalized in Dr. Moewardi Hospital, including ST-Elevation Myocardial Infarction (STEMI) and Non-ST-Elevation Myocardial Infarction (NSTEMI). Blood drawing, FMD examination and Diagnostic Coronary Angiography were performed. In order to find the correlation between DPP-4 with FMD and SYNTAX score I, Product Moment Pearson correlation test was used in data with normal distribution, and Rank Spearman test in data with abnormal distribution. Multiple correlation statistic test was used to establish the correlation between DPP-4 and FMD with SYNTAX score I.

Result: Forty patients were involved in the current study (32 males, 8 females). Between DPP-4 and FMD was proved to have strong negative and significant correlation (r = -0,49; p = 0,001). DPP-4 and SYNTAX score I were positively strong and significantly correlated (r = 0,373; p = 0,019). The result of multiple correlation analysis using regression statistic analysis show DPP-4 and FMD together correlated to SYNTAX score I significantly (R = 0,556, p = 0,001).

Conclusion: DPP-4 activity was proved to be correlated with endothelial dysfunction measured by FMD and complexity coronary artery lesion assessed by SYNTAX score I in patients with acute myocardial infarction.

Keywords: dipeptidyl-peptidase-4, flow mediated dilatation, SYNTAX score I.