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Adiponectin is associated with increased mortality and heart failure in patients with stable ischemic heart disease: data from the Heart and Soul Study.
Atherosclerosis. 2012 Feb; 220(2):587-92.A

Abstract

OBJECTIVE

Serum adiponectin protects against incident ischemic heart disease (IHD). However, in patients with existing IHD, higher adiponectin levels are paradoxically associated with worse outcomes. We investigated this paradox by evaluating the relationship between adiponectin and cardiovascular events in patients with existing IHD.

METHODS

We measured total serum adiponectin and cardiac disease severity by stress echocardiography in 981 outpatients with stable IHD who were recruited for the Heart and Soul Study between September 2000 and December 2002. Subsequent heart failure hospitalizations, myocardial infarction, and death were recorded.

RESULTS

During an average of 7.1 years of follow-up, patients with adiponectin levels in the highest quartile were more likely than those in the lowest quartile to be hospitalized for heart failure (23% vs. 13%; demographics-adjusted hazard ratio (HR) 1.63, 95% confidence interval (CI) 1.04-2.56, p=0.03) or die (49% vs. 31%; HR 1.67, 95% CI 1.24-2.26, p<0.008), but not more likely to have a myocardial infarction (12% vs. 17%; HR 0.64, 95% CI 0.38-1.06, p=0.08). The combined outcome of myocardial infarction, heart failure, or death occurred in 56% (136/245) of participants in the highest quartile of adiponectin vs. 38% (94/246) of participants in the lowest quartile (HR 1.54, 95% CI 1.31-2.21, p<0.002). Adjustment for left ventricular ejection fraction, diastolic dysfunction, inducible ischemia, C-reactive protein, and NT-proBNP attenuated the association between higher adiponectin and increased risk of subsequent events (HR 1.43, 95% CI 0.98-2.09, p=0.06).

CONCLUSIONS

Higher concentrations of adiponectin were associated with heart failure and mortality among patients with existing IHD.

Authors+Show Affiliations

Department of Medicine, University of California, San Francisco, CA, USA. alexis.beatty@ucsf.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

22196150

Citation

Beatty, Alexis L., et al. "Adiponectin Is Associated With Increased Mortality and Heart Failure in Patients With Stable Ischemic Heart Disease: Data From the Heart and Soul Study." Atherosclerosis, vol. 220, no. 2, 2012, pp. 587-92.
Beatty AL, Zhang MH, Ku IA, et al. Adiponectin is associated with increased mortality and heart failure in patients with stable ischemic heart disease: data from the Heart and Soul Study. Atherosclerosis. 2012;220(2):587-92.
Beatty, A. L., Zhang, M. H., Ku, I. A., Na, B., Schiller, N. B., & Whooley, M. A. (2012). Adiponectin is associated with increased mortality and heart failure in patients with stable ischemic heart disease: data from the Heart and Soul Study. Atherosclerosis, 220(2), 587-92. https://doi.org/10.1016/j.atherosclerosis.2011.11.038
Beatty AL, et al. Adiponectin Is Associated With Increased Mortality and Heart Failure in Patients With Stable Ischemic Heart Disease: Data From the Heart and Soul Study. Atherosclerosis. 2012;220(2):587-92. PubMed PMID: 22196150.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adiponectin is associated with increased mortality and heart failure in patients with stable ischemic heart disease: data from the Heart and Soul Study. AU - Beatty,Alexis L, AU - Zhang,Mary H, AU - Ku,Ivy A, AU - Na,Beeya, AU - Schiller,Nelson B, AU - Whooley,Mary A, Y1 - 2011/12/07/ PY - 2011/10/14/received PY - 2011/11/10/revised PY - 2011/11/28/accepted PY - 2011/12/27/entrez PY - 2011/12/27/pubmed PY - 2012/5/23/medline SP - 587 EP - 92 JF - Atherosclerosis JO - Atherosclerosis VL - 220 IS - 2 N2 - OBJECTIVE: Serum adiponectin protects against incident ischemic heart disease (IHD). However, in patients with existing IHD, higher adiponectin levels are paradoxically associated with worse outcomes. We investigated this paradox by evaluating the relationship between adiponectin and cardiovascular events in patients with existing IHD. METHODS: We measured total serum adiponectin and cardiac disease severity by stress echocardiography in 981 outpatients with stable IHD who were recruited for the Heart and Soul Study between September 2000 and December 2002. Subsequent heart failure hospitalizations, myocardial infarction, and death were recorded. RESULTS: During an average of 7.1 years of follow-up, patients with adiponectin levels in the highest quartile were more likely than those in the lowest quartile to be hospitalized for heart failure (23% vs. 13%; demographics-adjusted hazard ratio (HR) 1.63, 95% confidence interval (CI) 1.04-2.56, p=0.03) or die (49% vs. 31%; HR 1.67, 95% CI 1.24-2.26, p<0.008), but not more likely to have a myocardial infarction (12% vs. 17%; HR 0.64, 95% CI 0.38-1.06, p=0.08). The combined outcome of myocardial infarction, heart failure, or death occurred in 56% (136/245) of participants in the highest quartile of adiponectin vs. 38% (94/246) of participants in the lowest quartile (HR 1.54, 95% CI 1.31-2.21, p<0.002). Adjustment for left ventricular ejection fraction, diastolic dysfunction, inducible ischemia, C-reactive protein, and NT-proBNP attenuated the association between higher adiponectin and increased risk of subsequent events (HR 1.43, 95% CI 0.98-2.09, p=0.06). CONCLUSIONS: Higher concentrations of adiponectin were associated with heart failure and mortality among patients with existing IHD. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/22196150/Adiponectin_is_associated_with_increased_mortality_and_heart_failure_in_patients_with_stable_ischemic_heart_disease:_data_from_the_Heart_and_Soul_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(11)01110-5 DB - PRIME DP - Unbound Medicine ER -