Abstract 2064: Resistin, Acute Coronary Syndrome and Prognosis: Results from the AtheroGene Study
Objective Resistin, an adipocyte and macrophage derived cytokine, causes insulin resistance and glucose intolerance. We investigated the impact of resistin as a diagnostic marker in patients with acute coronary syndrome and its prognostic value for future cardiovascular events.
Methods Resistin levels were determined in 1153 patients with stable angina (SAP), 380 patients with unstable angina, 278 patients with non ST-elevation myocardial infarction (NSTEMI) and 111 patients with ST-elevation myocardial infarction (STEMI). All patients have been followed up for a median follow up of 2.6 years. During follow up, 70 patients died from cardiovascular causes.
Results Compared to SAP, resistin levels (5.1 ng/mL in SAP) were elevated in patients with angina at rest (5.89 ng/mL, P=0.001), in patients with NSTEMI (6.00 ng/mL, P<0.001), and in patients with STEMI (5.98 ng/mL, P<0.001). Resistin levels rose at 3 to 6 hours after chest pain onset (5.46 ng/mL), persisted elevated among those individuals presenting between 6 and 12 hours after chest pain onset (5.57 ng/mL) and peaked in individuals presenting more than 12 hours after chest pain onset (5.74 ng/mL). An increase of one standard deviation of resistin levels was associated with a 1.22-fold (95% CI 1.04 –1.43; P=0.02) risk for future fatal cardiovascular events in a model adjusted for risk factors and clinical and therapeutic variables. When adjustment for renal function was applied, this association lost its statistical significance.
Conclusions Resistin levels are elevated in patients presenting with unstable angina, NSTEMI and STEMI and might play a role as a diagnostic marker. In addition, systemic resistin level is moderately associated with future cardiovascular death in patients with documented coronary artery disease.