Future adverse cardiac events can be predicted by persistently low plasma adiponectin concentrations in men and marked reductions of adiponectin in women after acute myocardial infarction.
There is conflicting information about whether mortality after AMI is higher in women than men. We investigated the significance of plasma adiponectin concentrations on major adverse cardiac events (MACE) after acute myocardial infarction (AMI) to delineate any differences between men and women. The study patients consisted of 114 men and 42 women with AMI. The incidence of MACE was significantly higher in women than men during the entire follow-up period (p<0.05). Compared with men for post-AMI MACE, the hazard ratio for women was 5.6 after adjustment for prognostic factors. Killip class (p<0.001) and sex differences (p<0.05) were independent predictors of MACE at 1 year post-AMI. Plasma adiponectin levels in women were significantly higher than men on admission (8.66 microg/mL [range: 6.6-14.08] versus 4.71 microg/mL [range: 3.47-7.27], p<0.0001) and during the post-AMI course (all p<0.0001). Multivariate analysis identified plasma adiponectin level on admission as an independent predictor of MACE in men (p<0.001) and the difference between plasma adiponectin levels at discharge and on admission in women (p<0.05). Patterns of serial changes in plasma adiponectin concentrations are different between men and women and plasma adiponectin concentrations can be used to predict future adverse cardiac events in AMI patients.
Kojima
Sunao
S
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto City 860-8556, Japan. kojimas@kumamoto-u.ac.jp
Funahashi
Tohru
T
Otsuka
Fumiyuki
F
Maruyoshi
Hidetomo
H
Yamashita
Takuro
T
Kajiwara
Ichiro
I
Shimomura
Hideki
H
Miyao
Yuji
Y
Fujimoto
Kazuteru
K
Sugiyama
Seigo
S
Sakamoto
Tomohiro
T
Yoshimura
Michihiro
M
Ogawa
Hisao
H
D000208:Acute Disease; D052242:Adiponectin / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012008:Recurrence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution
D052242:Adiponectin; D015415:Biomarkers