Abstract 16583: Variations of Circulating Levels of Adiponectin Impact Two-Years Cardiovascular Outcomes in Patients With Acute Myocardial Infarction
Background: Adiponectin is a circulating adipose-derived cytokine with anti-inflammatory and antiatherosclerotic properties. Low adiponectin concentrations are related with endothelial dysfunction, hypertension, and incidence of type 2 diabetes. However the relationship of adiponectin concentrations and cardiovascular outcomes in patients with pre-existing cardiovascular disease is unclear.
Methods: We used data from patients enrolled in the prospective, multicentre French registry of Acute ST elevation or non-ST-elevation Myocardial Infarction(Fast-MI). Blood samples were drawn immediately at admission. Adiponectin concentrations were measured using a validated immunoassay (n= 932 patients, of whom 279 with diabetes). Cox proportional hazards regression models were used for assessing outcomes, e.g all-cause mortality and recurrent AMI during a 2-year follow-up, according to adiponectin levels as continuous variable and tertiles.
Results: During follow-up, 162(17%) patients died or had a recurrent AMI. High concentrations of adiponectin was an independent correlate of the risk of death or recurrent MI, after adjustment for known cardiovascular factors, including BMI, renal dysfunction, levels of CRP, glycaemia, and treatments, (adjusted HR 1.70, 95%CI=1.24-2.32; p= 0.0009. The corresponding hazard risks were 1.83, 95%CI=1.15-2.9, and 1.38, 95%CI=0.88 - 2.16, when the analyses were restricted to diabetic and non-diabetic patients respectively. After adjustment, higher tertiles of adiponectin levels remained also associated with increased risk of death and recurrent MI in the overall population (fig.1).
Conclusion: Elevated levels of adiponectin are associated with a higher risk of death and recurrent AMI in patients with acute MI, in particular in those patients with diabetes.
- © 2013 by American Heart Association, Inc.