G. Y. H. L. and V. R. are joint senior authors.
The prognostic role of the adiponectin levels in atrial fibrillation
Version of Record online: 20 DEC 2012
© 2012 The Authors. European Journal of Clinical Investigation © 2012 Stichting European Society for Clinical Investigation Journal Foundation
European Journal of Clinical Investigation
Volume 43, Issue 2, pages 168–173, February 2013
How to Cite
Eur J Clin Invest 2013; 43 (2): 168–173
- Issue online: 18 JAN 2013
- Version of Record online: 20 DEC 2012
- Accepted manuscript online: 20 NOV 2012 03:57AM EST
- Manuscript Accepted: 14 NOV 2012
- Manuscript Received: 24 SEP 2012
Vol. 43, Issue 4, 428, Version of Record online: 18 MAR 2013
- atrial fibrillation;
- oral anticoagulant treatment;
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 CHA2DS2-VASc was 4 (3–5)]. Plasma adiponectin was determined by ELISA. Clinical follow-up and cardiovascular adverse events were recorded.
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.
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.