Serial changes in adiponectin and BNP in ACS patients: paradoxical associations with each other and with prognosis - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Clinical Science Année : 2009

Serial changes in adiponectin and BNP in ACS patients: paradoxical associations with each other and with prognosis

Donald Sc Ang
  • Fonction : Auteur
Pauline H Watt
  • Fonction : Auteur
Scott M Nelson
  • Fonction : Auteur
Allan D Struthers
  • Fonction : Auteur
Naveed Sattar

Résumé

Plasma adiponectin is inversely associated with risk of coronary heart disease in healthy people. However, adiponectin and B-type natriuretic peptide (BNP) are both known to be positively associated with risk of poor outcome, and with each other, in acute coronary syndrome (ACS) patients. Serial changes in plasma adiponectin and BNP following ACS have not been assessed previously, and may clarify these apparently paradoxical associations. In this study, adiponectin, BNP, classical risk markers, and clinical parameters were measured on plasma from 442 consecutive ACS patients in an urban teaching hospital, with repeat measures at 7 weeks (n=338). Patients were followed-up for 10 months. Poor outcome was defined as mortality or readmission for ACS or congestive heart failure (n=90). In unadjusted analysis, change in adiponectin (but not baseline or 7 week adiponectin) was significantly associated with risk of adverse outcome: odds ratio (OR) 5.42 (95% CI 2.78 – 10.55). This association persisted after adjusting for classical risk factors and clinical markers, but was fully attenuated by adjusting for the 7 week BNP measurement [1.13 (0.27 – 4.92)], which itself remained associated with risk [5.86 (1.04 – 32.94)]. Adiponectin and BNP positively correlated at baseline, 7 weeks, and change in both parameters over 7 weeks also correlated (r=0.39, p<0.001). In conclusion, increases in plasma adiponectin (rather than absolute levels) after ACS are related to risk of adverse outcome, but this relationship is not independent of BNP levels. Our results allude to a potential direct or indirect relationship between adiponectin and BNP post-ACS that requires further investigation.

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Dates et versions

hal-00488426 , version 1 (02-06-2010)

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Donald Sc Ang, Paul Welsh, Pauline H Watt, Scott M Nelson, Allan D Struthers, et al.. Serial changes in adiponectin and BNP in ACS patients: paradoxical associations with each other and with prognosis. Clinical Science, 2009, 117 (1), pp.41-48. ⟨10.1042/CS20080506⟩. ⟨hal-00488426⟩

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