Serum Adiponectin and Cardiometabolic Risk in Patients with Acute Coronary Syndromes

Abstract

BackgroundThe adipose tissue is considered not only a storable energy source, but mainly an endocrine organ that secretes several cytokines. Adiponectin, a novel protein similar to collagen, has been found to be an adipocyte-specific cytokine and a promising cardiovascular risk marker.ObjectivesTo evaluate the association between serum adiponectin levels and the risk for cardiovascular events in patients with acute coronary syndromes (ACS), as well as the correlations between adiponectin and metabolic, inflammatory, and myocardial biomarkers.MethodsWe recruited 114 patients with ACS and a mean 1.13-year follow-up to measure clinical outcomes. Clinical characteristics and biomarkers were compared according to adiponectin quartiles. Cox proportional hazard regression models with Firth's penalization were applied to assess the independent association between adiponectin and the subsequent risk for both primary (composite of cardiovascular death/non-fatal acute myocardial infarction (AMI)/non-fatal stroke) and co-primary outcomes (composite of cardiovascular death/non-fatal AMI/non-fatal stroke/ rehospitalization requiring revascularization).ResultsThere were significant direct correlations between adiponectin and age, HDL-cholesterol, and B-type natriuretic peptide (BNP), and significant inverse correlations between adiponectin and waist circumference, body weight, body mass index, Homeostasis Model Assessment (HOMA) index, triglycerides, and insulin. Adiponectin was associated with higher risk for primary and co-primary outcomes (adjusted HR 1.08 and 1.07/increment of 1000; p = 0.01 and p = 0.02, respectively).ConclusionIn ACS patients, serum adiponectin was an independent predictor of cardiovascular events. In addition to the anthropometric and metabolic correlations, there was a significant direct correlation between adiponectin and BNP.

Ocena stężeń adiponektyny i leptyny w surowicy u pacjentów z chorobą niedokrwienną serca — związek z frakcją wyrzutową, wskaźnikiem uwapnienia tętnic i angiogramem tętnic wieńcowych

“…The results of this study showed significant paradoxical alterations of serum leptin levels, and non-significant changes in serum adiponectin levels in patients with ischaemic heart disease. Cardio-metabolic risk factors in terms of overweight-obesity and abnormal lipid profile (high fasting serum triglycerides and low high-density lipoprotein) were detected in considerable percent and in agreement with other studies [19,20]. The data of coronary calcium score revealed, that 18 patients were at risk of future myocardial infarction.…”

A comparative study of serum adiponectin levels in patients of acute coronary syndrome with and without central obesity

“…8 Similarly, a study which was done in Brazil by Gustavo et al, who included the patients with acute coronary syndrome found out reduced adiponectin levels in the cases and also showed the prognostic importance of serum adiponectin level for further cardiovascular events. 9 The relation between serum adiponectin level and central obesity was more specific and was not totally dependent on BMI as patient with normal BMI had significantly raised waist to hip ratio and reduced serum adiponectin level as was indicated in a study done by Chiara et al, who said that hypoadiponectinemia played an important role in metabolic syndrome and cardiovascular disease. 10 Hence it was observed from the study that serum adiponectin level was decreased in patients with acute coronary syndrome and even more reduction of adiponectin level was found in ACS patients with central obesity.…”

Increased serum adiponectin predicts improved coronary flow and clinical outcomes in patients with ST‐segment elevation myocardial infarction treated by primary percutaneous coronary intervention

“…Several clinical trials have suggested an inverse correlation of circulating APN level with adverse outcomes in patients with AMI . However, the results of other studies are contradictory . Animal studies showed that myocardial ischemia/reperfusion (MI/R) injury was severe in the APN knockout mice, which was ameliorated by administering exogenous APN .…”

“…1,2 But the relationship between plasma APN level and prognosis of AMI remains controversial. [3][4][5][6][7][8][9] Several clinical trials have suggested an inverse correlation of circulating APN level with adverse outcomes in patients with AMI. [7][8][9] However, the results of other studies are contradictory.…”

“…[7][8][9] However, the results of other studies are contradictory. [3][4][5][6] Animal studies showed that myocardial ischemia/reperfusion (MI/R) injury was severe in the APN knockout mice, which was ameliorated by administering exogenous APN. 10,11 Also, APN could improve vascular endothelial function via its ability to increase nitric oxide production.…”