Adiponectin and Long-Term Mortality in Coronary Artery Disease Participants and Controls (original) (raw)
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Adiponectin and Mortality in Patients Undergoing Coronary Angiography
The Journal of Clinical Endocrinology & Metabolism, 2006
Context: The adipokine adiponectin has been suggested to protect from coronary artery disease (CAD). However, studies addressing the association between adiponectin and mortality are sparse. Objective: To elucidate the relationship between adiponectin and mortality. Design, Setting and Participants: Adiponectin was determined in 2473 persons with and 673 persons without angiographic CAD. During a mean follow-up period of 5.45 years, 427 persons with CAD and 55 persons without CAD died. Main Outcome Measure: Hazard ratios for mortality according to adiponectin levels. Results: Adiponectin was positively related to female gender, age, LDL cholesterol, HDL cholesterol, homocysteine, and N-terminal pro-B-type natriuretic peptide. It was inversely related to glomerular filtration rate, body mass index and triglycerides and was low in diabetes mellitus and CAD. An increase of one standard deviation in adiponectin was associated with unadjusted and fully adjusted hazard ratios for death from any cause of 1.31 (95% confidence interval [CI] 1.20-1.42) and 1.22 (95% CI 1.12-1.34), and for death from cardiovascular causes of 1.32 (95% CI 1.19-1.45) and 1.23 (95% CI 1.11-1.37), respectively. In angiographic CAD, stable CAD and unstable CAD, the predictive value of adiponectin was similar to that in the entire cohort, but it did not attain statistical significance in persons without angiographic CAD. Adiponectin was also positively related to the risk of death from noncardiovascular causes. Conclusions: Despite the common view about adiponectin as a protective molecule in cardiovascular disease high adiponectin independently predicts all-cause, cardiovascular and non-cardiovascular mortality in individuals with CAD.
Aims: There are large differences in all-cause and cardiovascular disease (CVD) mortality between eastern and western countries in Europe. We reviewed the development of these mortality trends in countries of the European Union (EU) over the past 40 years and evaluated available data regarding possible determinants of these differences. Methods and results: We summarized all-cause mortality and specific cardiovascular mortality for two country groups – 10 countries that joined the European Union (EU) after 2004 (East), and 15 countries that joined before 2004 (West). Standardized mortality rates were retrieved from the World Health Organization ''European Health for All'' database for each country between 1970 and 2007. Currently (in the 2000s), mortality due to circulatory system disease, ischemic heart disease (IHD), cerebrovascular disease (CBVD), and all-causes in the 'new' EU countries (East) is approximately twice that in the 'old' EU countries (West). These differences were much smaller in the 1970s. The increasing gap in mortality between West and East is primarily the result of a continuous and rapid improvement in the West. Conclusion: Differences in lifestyle (i.e. diet, alcohol consumption, physical activity, and smoking) provide insufficient explanation for the observed mortality gap in these two groups of EU countries. Higher expenditures on health, better access to invasive and acute cardiac care, and better pharmacological control of hypertension and hypercholesterolemia in the West are well documented. Socioeconomic and psychosocial factors may also contribute to the changes in mortality trends.
Atherosclerosis Supplements, 2008
Poster Sessions 78 PO21 Epidemiology of CVD orders. Among its clinical presentation, stroke and ischemic heart disease are the most important. Population based studies of stroke are scant, mostly have done in developed countries. Mashhad stroke incidence study is a large cohort study which has performed in Mashhad, the second most important city of Iran. This study was designed to evaluate incidence, causes, and final outcome of stroke in Iran. Methods: Any adult citizen of Mashhad with different Middle-East nationality (Persian, Turkish, Kurdish, Afghani, Uzbek, Arab, Baluch) with definite diagnosis of the stroke entered this study since December 2006. We monitored about 500000 inhabitants with high, moderate and low socioeconomic class. A large group of volunteer helped us to find any cases who did not admitted in the hospitals. Each volunteer is responsible for health problem in a small street and a few families and checked participants every two weeks. Demographic data, special vascular information, and laboratory samples included nail, hair, serum and blood for DNA extraction were collected. Result: The preliminary result of this ongoing study showed 720 registered case of stroke with 140 deaths. We managed to take blood sample in acute phase of stroke in 320 cases. Discussion: The result of this study showed different cause and incidence for stroke in Iran. The samples are large enough for further clinical as well as laboratory studies particularly in basic atherosclerotic concepts. Middle-East countries need to manage their major health problems based on population based study.
Plasma Adiponectin for Prediction of Cardiovascular Events and Mortality in High-Risk Patients
The Journal of Clinical Endocrinology & Metabolism, 2008
The prognostic value of plasma levels of adiponectin, an adipocytokine with antiatherogenic, antiinflammatory, and insulin-sensitizing effects, is contentious. Objective: The objective of the study was to investigate whether plasma adiponectin levels predict cardiovascular (CV) events and mortality in high-risk coronary artery disease (CAD) patients. Design, Setting, Participants, and Main Outcome Measure: We measured plasma adiponectin and examined its impact on the incidence of CV deaths and events at follow-up in the context of all potentially relevant background covariates in 712 high-risk patients of the Genetic and ENvironmental factors in Coronary Atherosclerosis study who underwent coronary angiography for suspected CAD. Based on the population plasma adiponectin median (6.38 g/ml, interquartile range 4.2-10.2), we split the patients in a high-and a low-plasma adiponectin subgroup. After a median follow-up of 3.8 years (interquartile range 3.3-4.3 yr), outcome data were obtained in 100% of the patients and 45 CV deaths (6.4%) were recorded. Kaplan-Meier analysis unexpectedly showed a higher CV death rate in high-plasma adiponectin than low-plasma adiponectin patients. By contrast, multivariate Cox regression analysis, in which potential confounders, including ongoing medical treatment, were considered, showed no impact of plasma adiponectin on CV death. Similar negative results were obtained using the propensity score that considered all relevant covariables and medical treatment rate, which differed between the high-and low-plasma adiponectin group. Conclusions: In high-risk CAD patients, plasma adiponectin above the median (6.38 g/ml) implies a paradoxical higher risk of CV death. However, when relevant covariates that differ between highand low-plasma adiponectin groups are considered, this association wanes, indicating that the clustering of plasma adiponectin with other covariates can abolish its impact on CV prognosis.
International Journal of Biomedical and Advance Research, 2013
Background: This study was done to investigate the cause of death due to coronary artery pathology found on autopsy study conducted from the time period of November 2007 to October 2012. The study was conducted at the Histopathology laboratory, Pathology Department, P. D. U. Government Medical College, Rajkot (Gujarat, India). Methods: In the present study, there were total 350 postmortem cases with coronary artery specimen received from Saurashtra region (formed by seven districts of Gujarat, India) from November 2007 to October 2012 considered. Histopathological sections of these specimens were done & slides were prepared by staining with Hematoxylin & Eosin (H&E) for examining microscopically about coronary artery pathology. Autopsy cases were considered irrespective of cause of death (natural, unnatural or sudden death) for this study. Patients' relatives were approached and detailed history was elicited about patient's personal history and medical history etc... Results: A direct relationship was observed between death due to coronary artery disease and personal history including risk factors like sedentary life style, smoking, alcohol, obesity, diabetes & also with particular age groups viz. 45-65 years. Conclusions: Our study confirms that coronary artery diseases are more common among the population with risk factors like sedentary life style, habit of smoking, alcohol, obesity and in patients with diabetes & hypertension. These signify, increasing incidence of coronary artery diseases with modernization & adaptation of western lifestyle in the developing countries as emphasized in our study population. This information is valuable in policy formation for the control of coronary artery diseases.
Doença Cardiovascular Associada à Mortalidade em Idosos com Sepse Grave e Choque Séptico
Objetivo: Avaliar a associação da Doença Cardiovascular (DCV) prévia com a mortalidade de idosos com sepse grave e choque séptico. Métodos: Coorte de 37 pacientes com idade ≥ 65 anos, portadores de sepse grave e choque séptico. Foram avaliados: SOFA nos dias 1, 3, 5, 7, 14 e 28, ∆ SOFA, APACHE II, troponina I, BNP, PCR, falências orgânicas, DCV prévia, entre outras. Para a análise estatística empregaram-se os testes t de Student, o teste exato de Fischer e o qui-quadrado, considerando-se 5% como nível de significância. Resultados: A média de idade dos pacientes foi de 82 anos (DP=9), e 60% eram do sexo feminino. O diagnóstico predominante foi choque séptico (67%). O APACHE médio foi de 20 (DP=6). O SOFA nos dias 1, 3, 5, 7, 14, 28 teve, como média, respectivamente 7, 6, 4, 3, 2, 2, mostrando-se significativamente relacionados com a mortalidade apenas o SOFA dos dias 1 (p=0,0001) e 3 (p=0,001), bem como o ∆ SOFA entre os dias 1 e 3 (p=0,043). O número de falências também se associou com a mortalidade, quando presentes duas ou mais falências orgânicas (p=0,001). A presença de DCV (p=0,035) e de BNP acima 100pg/ml (p=0,014) mostraram associação com a mortalidade, ainda que o aumento da troponina não mostrasse o mesmo. Conclusão: A presença de DCV, a piora do SOFA nas primeiras 72 horas, a evolução com duas ou mais falências orgânicas e o aumento do BNP se relacionaram com a mortalidade em idosos com choque séptico e sepse grave e deveriam ser estudados como potenciais candidatos para os modelos de predição de óbito nesses pacientes.