Correlation between circulating adiponectin levels and coronary plaque regression during aggressive lipid-lowering therapy in patients with acute coronary syndrome: subgroup analysis of JAPAN-ACS study.
OBJECTIVE
The Japan assessment of pitavastatin and atorvastatin in acute coronary syndrome (JAPAN-ACS) study demonstrated that aggressive lipid-lowering therapy with a statin resulted in a significant regression of coronary atherosclerotic plaques in patients with ACS. Adiponectin is an adipocyte-derived protein with anti-atherogenic properties. Here, we investigated the association between adiponectin levels and the change in the plaque volume in ACS patients.


METHODS
Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) was undertaken, followed by the initiation of statin treatment, in 238 patients with ACS. Follow-up IVUS was performed between 8 and 12 months after the PCI. The percent change in the plaque volume (%PV) in a non-culprit coronary artery segment was evaluated. The serum adiponectin and lipid parameters were measured both at baseline and at the follow-up.


RESULTS
At baseline, adiponectin was correlated positively with HDL-cholesterol and negatively correlated with triglyceride, but no correlation was observed with the PV. Adiponectin levels increased significantly from 7.8+/-4.6 microg/mL at baseline to 10.3+/-6.9 microg/mL at the 8-12 months follow-up. The increase in adiponectin was also associated with an increase of HDL-cholesterol and decrease of triglyceride, however, no significant correlation was observed with the %PV. A significantly higher incidence of major adverse cardiac events (MACE) was observed in patients with hypo-adiponectinemia at baseline. A multiple logistic regression analysis identified adiponectin as a significant independent predictor of MACE.


CONCLUSIONS
Adiponectin levels measured after PCI could serve as a marker of MACE in patients with ACS.
Ohashi
Taiki
T
Department of Cardiology, Yokkaichi Municipal Hospital, Yokkaichi, Japan.
Shibata
Rei
R
Morimoto
Takeshi
T
Kanashiro
Masaaki
M
Ishii
Hideki
H
Ichimiya
Satoshi
S
Hiro
Takafumi
T
Miyauchi
Katsumi
K
Nakagawa
Yoshihisa
Y
Yamagishi
Masakazu
M
Ozaki
Yukio
Y
Kimura
Takeshi
T
Daida
Hiroyuki
H
Murohara
Toyoaki
T
Matsuzaki
Masunori
M
D054058:Acute Coronary Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D052242:Adiponectin / Q000097:blood; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects*; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use*; D011804:Quinolines / Q000627:therapeutic use*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D018084:Ultrasonography, Interventional; D015854:Up-Regulation
C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D008076:Cholesterol, HDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D011804:Quinolines; D014280:Triglycerides; D000069059:Atorvastatin; C108475:pitavastatin