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The prognostic role of the adiponectin levels in atrial fibrillation
Author(s) -
HernándezRomero Diana,
Jover Eva,
Marín Francisco,
Vilchez Juan A.,
ManzanoFernandez Sergio,
Romera Marta,
Vicente Vicente,
Valdés Mariano,
Lip Gregory Y. H.,
Roldán Vanessa
Publication year - 2013
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12028
Subject(s) - adiponectin , medicine , atrial fibrillation , cardiology , biomarker , confounding , stroke (engine) , risk factor , obesity , insulin resistance , mechanical engineering , biochemistry , chemistry , engineering
Background Patients with atrial fibrillation ( AF ) have a high morbidity and mortality from vascular events, even despite oral anticoagulation ( OAC ). Rather than being a risk factor, AF has been proposed as a risk marker, being a signal of advanced atherosclerosis. Circulating adiponectin levels, a cytokine with anti‐inflammatory and cardioprotector roles, are related to different atherosclerotic risk factors. The aim is to evaluate whether plasma adiponectin can be predictive of cardiovascular risk in anticoagulated patients with AF . Materials and methods We included 918 stable anticoagulated out patients with nonvalvular AF [50·1% male; median age 76 (70–80) years; median score for the stroke risk stratification scheme CHA 2 DS 2 ‐ VAS c was 4 (3–5)]. Plasma adiponectin was determined by ELISA . Clinical follow‐up and cardiovascular adverse events were recorded. Results After a median follow‐up of 956 (784–1085) days, 113 cardiovascular events were recorded (annual rate 4·70%/year) and 99 patients died (rate 4·12%/year). Low plasma adiponectin (< 4444 ng/mL) was significantly associated with major cardiovascular events in female patients [HR 2·96 (95%CI 1·78–4·92)]; P < 0·001, even after adjusting for clinical confounder factors. Adiponectin was neither predictive of stroke/thromboembolism nor all‐cause mortality in females, nor for any end‐point in males. Conclusions Adiponectin is suggested as an independent prognostic biomarker for cardiovascular events in anticoagulated female patients with AF . Our data reinforce the importance of AF as a risk marker of atherosclerotic vascular damage.