Abstract 3204: Assessment of Adiponectin and the Risk of Recurrent Cardiovascular Events: Observations from the PROVE IT-TIMI 22 Trial
Adiponectin, an adipocytokine, is a secretion product of white fatty cells and exerts a regulatory role in the development of atherosclerosis, modulating foam cell formation, upregulation of cellular adhesion molecules and insulin sensitization. Understanding of the impact of plasma adiponectin is evolving. Adiponectin has appeared to offer cardiovascular protection in patients with stable atherosclerosis. Recent data have raised a possible discordant adverse risk relationship in acute coronary syndrome. We measured plasma adiponectin in 3931 pts stabilized following acute coronary syndrome and assessed the relationship with outcome over 2 years. Using multivariable Cox regression, we adjusted for age, sex, diabetes, body mass index, smoking status, BNP, CRP and the qualifying acute coronary syndrome event. Adiponectin correlated negatively with age, diabetes, BMI, and creatinine clearance (each p<0.001). Adiponectin showed a graded relationship with the risk of death/MI/CHF (Figure⇓). After adjusting for risk factors, BNP and CRP, adiponectin remained independently associated with an increased risk of death or MI (Q4 vs Q1 HR 1.58; 95% CI 1.10 –2.28; p=0.013), congestive heart failure (HR 2.17; 95% CI 1.21–3.89; p=0.010) and the composite of death/MI/CHF (HR 1.75; 95% CI 1.26 –2.43; p=0.001). Increasing adiponectin levels after acute coronary syndrome are associated with a higher risk of recurrent cardiovascular events. This finding highlights the need for additional investigation to further elucidate the pathobiology of adipocytokines in patients with stable versus unstable coronary artery disease.