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The prognostic role of the adiponectin levels in atrial fibrillation

Authors

  • Diana Hernández-Romero,

    1. Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain
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  • Eva Jover,

    1. Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain
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  • Francisco Marín,

    1. Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain
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  • Juan A. Vilchez,

    1. Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain
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  • Sergio Manzano-Fernandez,

    1. Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain
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  • Marta Romera,

    1. Department of Hematology, Hospital Universitario Morales Meseguer, Universidad de Murcia, Murcia, Spain
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  • Vicente Vicente,

    1. Department of Hematology, Hospital Universitario Morales Meseguer, Universidad de Murcia, Murcia, Spain
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  • Mariano Valdés,

    1. Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain
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  • Gregory Y. H. Lip,

    1. Haemostasis, Thrombosis and Vascular Biology Unit, University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK
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    • G. Y. H. L. and V. R. are joint senior authors.

  • Vanessa Roldán

    Corresponding author
    1. Department of Hematology, Hospital Universitario Morales Meseguer, Universidad de Murcia, Murcia, Spain
    • Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain
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    • G. Y. H. L. and V. R. are joint senior authors.

Errata

This article is corrected by:

  1. Errata: Erratum Volume 43, Issue 4, 428, Article first published online: 18 March 2013

Correspondence to: Vanessa Roldán, Department of Hematology, Hospital Universitario Morales Meseguer, Universidad de Murcia, Murcia 30008, Spain. Tel.: +34 968360969; fax: +34 968360969; e-mail: vroldans@gmail.com

Abstract

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 CHA2DS2-VASc 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.

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