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Baseline adiponectin concentration and clinical outcomes among patients with diabetes and recent acute coronary syndrome in the EXAMINE trial
Author(s) -
Bergmark Brian A.,
Can Christopher P.,
White William B.,
Jarolim Petr,
Liu Yuyin,
Bonaca Marc P.,
Zannad Faiez,
Morrow David A.
Publication year - 2017
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12905
Subject(s) - medicine , adiponectin , interquartile range , acute coronary syndrome , hazard ratio , myocardial infarction , diabetes mellitus , population , cardiology , body mass index , quartile , confidence interval , endocrinology , insulin resistance , insulin , environmental health
Aim To investigate adiponectin levels and cardiovascular ( CV ) outcomes in patients with diabetes and recent acute coronary syndrome ( ACS ). Materials and methods We analysed baseline adiponectin concentration and CV outcomes in 5213 patients with type 2 diabetes enrolled in the EXAMINE trial of alogliptin vs placebo 15 to 90 days (median 45 days) after ACS . Event rates at 18 months are reported. Results The median (interquartile range) baseline adiponectin concentration was 5.2 (3.5‐7.9) μg/ mL . Patients with the highest baseline adiponectin concentration (quartile [ Q ]4) were at significantly higher risk of death from a CV event (8.4% vs 1.7%; P < .0001), hospitalization for heart failure ( HF ; 7.5% vs 1.7%; P < .0001), and all‐cause mortality (10.8% vs 2.4%; P < .0001) compared with those in Q1 . After adjusting for age, sex, index event, HF , estimated glomerular filtration rate and hypertension, adiponectin concentration in Q4 remained associated with an increased risk of death from CV causes (hazard ratio [ HR ] 2.43, 95% confidence interval [ CI ] 1.52, 3.88), all‐cause mortality ( HR 2.45, 95% CI 1.65, 3.64), and HF ( HR 2.44, 95% CI 1.47, 4.05), without change after stratification by body mass index. There was no significant difference in the rate of myocardial infarction or stroke. Conclusions In this contemporary population of patients with diabetes and ACS , adiponectin concentration was independently associated with increased risk of death from CV causes, all‐cause mortality, and hospitalization for HF . The relationship between adiponectin and CV outcomes is complex and deserves further study.