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Adiponectin in Relation to Coronary Plaque Characteristics on Radiofrequency Intravascular Ultrasound and Cardiovascular Outcome / Relação da Adiponectina com as Características da Placa Aterosclerótica ao Ultrassom Intravascular com Radiofrequência e Desfechos Cardiovasculares
Marino, Bárbara Campos Abreu; Buljubasic, Nermina; Akkerhuis, Martijn; Cheng, Jin M; Garcia-Garcia, Hector M; Regar, Evelyn; Geuns, Robert-Jan van; Serruys, Patrick W; Boersma, Eric; Kardys, Isabella.
  • Marino, Bárbara Campos Abreu; Erasmus MC. Department of Cardiology. Rotterdam. NL
  • Buljubasic, Nermina; Erasmus MC. Department of Cardiology. Rotterdam. NL
  • Akkerhuis, Martijn; Erasmus MC. Department of Cardiology. Rotterdam. NL
  • Cheng, Jin M; Erasmus MC. Department of Cardiology. Rotterdam. NL
  • Garcia-Garcia, Hector M; Washington Hospital Center. Washington DC. US
  • Regar, Evelyn; Erasmus MC. Department of Cardiology. Rotterdam. NL
  • Geuns, Robert-Jan van; Erasmus MC. Department of Cardiology. Rotterdam. NL
  • Serruys, Patrick W; Imperial College. London. GB
  • Boersma, Eric; Erasmus MC. Department of Cardiology. Rotterdam. NL
  • Kardys, Isabella; Erasmus MC. Department of Cardiology. Rotterdam. NL
Arq. bras. cardiol ; 111(3): 345-353, Sept. 2018. tab
Article in English | LILACS | ID: biblio-973748
ABSTRACT
Abstract

Background:

Prospective data on the associations of adiponectin with in-vivo measurements of degree, phenotype and vulnerability of coronary atherosclerosis are currently lacking.

Objective:

To investigate the association of plasma adiponectin with virtual histology intravascular ultrasound (VH-IVUS)-derived measures of atherosclerosis and with major adverse cardiac events (MACE) in patients with established coronary artery disease.

Methods:

In 2008-2011, VH-IVUS of a non-culprit non-stenotic coronary segment was performed in 581 patients undergoing coronary angiography for acute coronary syndrome (ACS, n = 318) or stable angina pectoris (SAP, n = 263) from the atherosclerosis-intravascular ultrasound (ATHEROREMO-IVUS) study. Blood was sampled prior to coronary angiography. Coronary plaque burden, tissue composition, high-risk lesions, including VH-IVUS-derived thin-cap fibroatheroma (TCFA), were assessed. All-cause mortality, ACS, unplanned coronary revascularization were registered during a 1-year-follow-up. All statistical tests were two-tailed and p-values < 0.05 were considered statistically significant.

Results:

In the full cohort, adiponectin levels were not associated with plaque burden, nor with the various VH-tissue types. In SAP patients, adiponectin levels (median[IQR] 2.9(1.9-3.9) µg/mL) were positively associated with VH-IVUS derived TCFA lesions, (OR[95%CI] 1.78[1.06-3.00], p = 0.030), and inversely associated with lesions with minimal luminal area (MLA) ≤ 4.0 mm2 (OR[95%CI] 0.55[0.32-0.92], p = 0.025). In ACS patients, adiponectin levels (median[IQR] 2.9 [1.8-4.1] µg/mL)were not associated with plaque burden, nor with tissue components. Positive association of adiponectin with death was present in the full cohort (HR[95%CI] 2.52[1.02-6.23], p = 0.045) and (borderline) in SAP patients (HR[95%CI] 8.48[0.92-78.0], p = 0.058). In ACS patients, this association lost statistical significance after multivariable adjustment (HR[95%CI] 1.87[0.67-5.19], p = 0.23).

Conclusion:

In the full cohort, adiponectin levels were associated with death but not with VH-IVUS atherosclerosis measures. In SAP patients, adiponectin levels were associated with VH-IVUS-derived TCFA lesions. Altogether, substantial role for adiponectin in plaque vulnerability remains unconfirmed.
RESUMO
Resumo Fundamento Faltam dados prospectivos sobre as associações de adiponectina com medidas in-vivo de grau, fenótipo e vulnerabilidade da aterosclerose coronariana.

Objetivo:

Investigar a associação da adiponectina plasmática com medidas de aterosclerose derivadas de ultrassonografia virtual intravascular (VH-IVUS) e eventos cardíacos adversos importantes (major adverse cardiac events - MACE) em pacientes com doença arterial coronariana estabelecida.

Métodos:

Em 2008-2011, a VH-IVUS de um segmento coronariano não estenótico não culpado foi realizado em 581 pacientes submetidos à angiografia coronariana para síndrome coronariana aguda (SCA, n = 318) ou angina pectoris estável (APE, n = 263) a partir do estudo de ultrassonografia aterosclerótica-intravascular (ATHEROREMO-IVUS). Sangue foi amostrado antes da angiografia coronária. Foram avaliados a carga de placa coronária, a composição tecidual, as lesões de alto risco, incluindo fibroateroma de capa fina (FCF) derivado de VH-IVUS. Mortalidade por todas as causas, SCA, e revascularização coronária não planejada foram registradas durante um ano de acompanhamento. Todos os testes estatísticos foram bicaudais e os valores de p < 0,05 foram considerados estatisticamente significativos.

Resultados:

Na coorte completa, os níveis de adiponectina não foram associados à carga de placa, nem a vários tipos de tecido virtual histológico. Entre os pacientes com APE, os níveis de adiponectina (mediana[IIQ] 2,9(1,9-3,9) µg/mL) foram associados positivamente às lesões FCF derivadas de VH-IVUS, (OR[IC 95%] 1,78[1,06-3,00], p = 0,030), e inversamente associados a lesões com área luminal mínima (ALM) ≤4,0 mm2 (OR[IC 95%] 0,55[0,32-0,92], p = 0,025). Em pacientes com SCA, os níveis de adiponectina (mediana[IIQ] 2,9 [1,8-4,1] µg/mL) não foram associados à carga de placa nem a componentes teciduais. A associação positive de adiponectina ao óbito esteve presente na coorte completa (HR[IC 95%] 2,52[1,02-6,23], p = 0,045) e (limítrofe) em pacientes com APE (HR[IC 95%] 8,48[0,92-78,0], p = 0,058). Entre pacientes com SCA, essa associação perdeu significância estatística após ajuste multivariado (HR[IC 95%] 1,87[0,67-5,19], p = 0,23).

Conclusão:

Na coorte completa, os níveis de adiponectina foram associados à obito, mas não a medidas de aterosclerose por VH-IVUS. Em pacientes com APE, os níveis de adiponectina foram associados a lesões FCF derivadas de VH-IVUS. Em geral, o papel da adiponectina na vulnerabilidade da placa permanece não confirmado.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Coronary Artery Disease / Ultrasonography, Interventional / Adiponectin / Plaque, Atherosclerotic Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Language: English Journal: Arq. bras. cardiol Journal subject: Cardiology Year: 2018 Type: Article Affiliation country: Netherlands / United States / United kingdom Institution/Affiliation country: Erasmus MC/NL / Imperial College/GB / Washington Hospital Center/US

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Full text: Available Index: LILACS (Americas) Main subject: Coronary Artery Disease / Ultrasonography, Interventional / Adiponectin / Plaque, Atherosclerotic Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Language: English Journal: Arq. bras. cardiol Journal subject: Cardiology Year: 2018 Type: Article Affiliation country: Netherlands / United States / United kingdom Institution/Affiliation country: Erasmus MC/NL / Imperial College/GB / Washington Hospital Center/US