Abstract 3477: Prognostic Value and Serial Changes of Plasma Adiponectin Concentration in Patients With Chronic Heart Failure. Data From the GISSI-HF Trial
Aims: Adiponectin, an adipocyte-specific cytokine abundant in plasma, is a marker of poor outcome in chronic heart failure (HF). We assessed the prognostic value of a single determination and serial changes in adiponectin concentration in HF and the effect of n-3 PUFA or statin.
Methods: Adiponectin (Delphia, Perkin Elmer) and NT-proBNP (Roche) were assayed at baseline and after 3 months in 1234 patients with chronic HF enrolled in the GISSI-HF trial, and randomized to n-3 PUFA (1 g/d) or rosuvastatin (10 mg/d) vs. placebo. Association between markers and mortality (follow-up 3.9 yrs) was tested with Kaplan-Meier curves and Cox models.
Results: Baseline adiponectin was inversely related to BMI (r=−0.28, p<0.0001), directly proportional to NT-proBNP (r=0.47, p<0.0001) and higher in the 333 patients who died (11.37 [7.43–17.73] mg/L) compared to the 901 survivors (8.43 [5.94 –12.25 mg/L], p<0.0001). Patients in the upper tertile of baseline adiponectin (>11.83 mg/L) had a higher risk of mortality compared to lower tertile (p<0.05) but not after adjustment for NT-proBNP. Patients with relative increase in adiponectin over 3 months had higher mortality (29.1%) than those with stable levels (21.7%, HR [95%CI] = 1.46 [1.09 –1.96], p=0.011). By univariate analysis, median adiponectin levels predicted mortality in normal and overweight but not in lean or obese patients (Table⇓). Adiponectin predicted mortality in the 172 patients with a non-intentional loss of body mass ≥2kg in the previous 6 months (p=0.0018), but not in those with intentional loss (n=194, p=0.34); NT-proBNP was predictive in both groups (p<0.0005). Compared to matching placebos, 3-month changes in adiponectin concentration were not different in the two arms.
Conclusions: Single measurement and serial changes in adiponectin are weak predictors of mortality in this large cohort of patients with chronic HF. Neither n-3 PUFA nor rosuvastatin had an effect on adiponectin plasma concentration.