Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Katsimardos Andreas
Dissertation committee:
Λεκάκης Ιωάννης, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ηλιοδρομίτης Ευστάθιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ραλλίδης Λουκιανός, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Δευτεραίος Σπυρίδων, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Φιλιππάτος Γεράσιμος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αλεξόπουλος Δημήτριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Παρίσης Ιωάννης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Ο προγνωστικός ρόλος της λιπονεκτίνης και της ρεζιστίνης σε ασθενείς με σταθερή στεφανιαία νόσο : Μελέτη παρακολούθησης τεσσάρων ετών
Translated title:
The prognostic role of adiponectin and resistin in patients with stable coronary artery disease: A 4-year prospective study
Summary:
Background and aims: Adiponectin has anti-atherogenic properties while resistin may promote atherosclerosis. However, studies investigating the role of adiponectin and resistin on clinical outcomes has led to conflicting results. We prospectively investigated the long-term prognostic value of adiponectin and resistin in patients with stable coronary artery disease (CAD) in the era of statins.
Methods: A total of 776 consecutive patients with stable CAD were recruited and followed for a median of 5 years. Serum adiponectin, resistin, lipids, high-sensitivity C-reactive protein (hs-CRP), intereleukin-6 (IL-6) and homocysteine levels were measured. Primary endpoints were cardiovascular (CV) deaths and secondary endpoints hospitalizations for acute coronary syndrome (ACS), arrhythmic event or stroke.
Results: Follow-up data were obtained from 713 patients of whom 79 had a CV death (11.1%) while 205 (28.8%) met the secondary endpoints. Five-hundred ninety-eight (83.9%) were on statins. Adiponectin was significantly positively correlated with hsCRP (r=0.075, p=0.037), IL-6 (r=0.107, p=0.018), and homocysteine (r=0.177, p <0.001). Resistin was significantly positively correlated with arterial hypertension (r=0.156, p <0.001), hs-CRP (r=0.167, p <0.001), IL-6 (r=0.161, p=0.002) and homocysteine (r=0.212, p <0.001). Adiponectin levels were independent predictors of CV death after adjustment for conventional risk factors for CAD (HR: 1.071; 95% CI: 1.040 - 1.104; p<0.001). Further adjustment for ejection fraction, hsCRP and statin treatment did not change the association (HR: 1.092; 95% CI: 1.053 - 1.133; p<0.001). Patients in the upper tertile of adiponectin (≥6.49 μg/mL) had 2.7 times higher risk of CV death compared to patients in the lower tertile (≤3.79 μg/mL) after adjustment for traditional risk factors for CAD (HR: 2.744; 95% CI: 1.542 - 4.882; p=0.001). The prognostic significance of resistin was not satistically significant for the occurrence of CV death (HR: 1.044; 95% CI: 0.994 – 1.096; p=0,087).
Conclusions: Adiponectin but not resistin is an independent predictor of CV death in patients with stable CAD in the era of statins.
Main subject category:
Health Sciences
Keywords:
Adiponectin, Resistin, Coronary artery disease
Number of references:
150
