title: High plasma adiponectin concentration is associated with all-cause mortality in patients with carotid atherosclerosis.
abstract: BACKGROUND
  The role of adiponectin as a risk factor for mortality and recurrent ischemic cardiovascular events in patients with carotid artery disease is unknown.
  
  
  METHODS
  Consecutive patients (n = 292) undergoing carotid endarterectomy for symptomatic and asymptomatic carotid stenosis were included in the study. Mortality and cardiovascular ischemic events were recorded during a median follow-up of 5.2 years. Baseline plasma concentrations of adiponectin were measured. Cox regression models stratified for gender were used for estimation of risk of events.
  
  
  RESULTS
  Fifty-two patients died and 73 had an ischemic event (ischemic stroke, n = 52 and/or MI, n = 28) during follow-up. In univariate analyses, adiponectin was associated with mortality, hazard ratio (HR) per standard deviation (SD) increase of adiponectin, 1.46 (95% confidence interval [CI], 1.14-1.86). In multivariate analysis age, type 2 diabetes mellitus (T2DM), coronary heart disease (CHD), plasma interleukin-6 (IL-6) and plasma adiponectin (HR per SD increase of adiponectin, 1.73 [95% CI, 1.29-2.32]) were independently associated with mortality. T2DM, CHD, fibrinogen, contralateral carotid artery stenosis, systolic blood pressure, symptomatic carotid artery stenosis were independently associated with ischemic events, whereas plasma adiponectin was not (HR per SD increase of adiponectin, 0.96 [95% CI, 0.75-1.23]).
  
  
  CONCLUSIONS
  High plasma adiponectin concentration is associated with mortality in patients with established atherosclerosis undergoing surgery for carotid artery stenosis. Further studies to determine the role for adiponectin as a biomarker are warranted.
authors.affiliation: Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Sweden. jonas.persson@ds.se
authors.forename: Jonas
authors.initials: J
authors.lastname: Persson
authors.forename: Lasse
authors.initials: L
authors.lastname: Folkersen
authors.forename: Johan
authors.initials: J
authors.lastname: Ekstrand
authors.forename: Johan
authors.initials: J
authors.lastname: Helleberg
authors.forename: Anders
authors.initials: A
authors.lastname: Gabrielsen
authors.forename: Pia
authors.initials: P
authors.lastname: Lundman
authors.forename: Ulf
authors.initials: U
authors.lastname: Hedin
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Paulsson-Berne
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000401:mortality; D016893:Carotid Stenosis / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D015897:Comorbidity; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000401:mortality; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000401:mortality; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers