Total adiponectin is inversely associated with platelet activation and CHA₂DS₂-VASc score in anticoagulated patients with atrial fibrillation.
BACKGROUND
Adiponectin (APN) possesses anti-inflammatory and antiatherogenic effects. Atrial fibrillation (AF) is burdened by enhanced systemic inflammation and platelet activation, as documented by increased blood levels of soluble CD40L (sCD40L). The interplay between APN and platelet activation in AF is still undefined.


METHODS
Circulating levels of APN and sCD40L were measured in 257 anticoagulated nonvalvular AF patients. Exclusion criteria were as follows: prosthetic heart valves, cardiac revascularization in the previous year, severe cognitive impairment, chronic infectious or autoimmune diseases, and active cancer.


RESULTS
Mean age was 72.9 (±8.7) years and 41.6% were female. Serum APN and plasmatic sCD40L were inversely correlated (R -0.626, P < 0.001). A progressive increase of sCD40L across tertiles of CHA2DS2-VASc score was observed (rS 0.473, P < 0.001), whilst APN was inversely correlated (rS -0.463,  P < 0.001). A multivariable linear regression analysis showed that CHA2DS2-VASc score (B -0.227, P < 0.001) and sCD40L (B -0.524, P < 0.001) correlated to APN.


CONCLUSIONS
AF patients at high risk of stroke disclose low and high levels of APN and sCD40L, respectively, suggesting a role for APN if it favors platelet activation in vivo in this clinical setting. Enhancing APN levels may be a future goal to reduce the risk of vascular outcomes in AF patients.
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00161 Rome, Italy.
Roberto
R
Carnevale
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00161 Rome, Italy.
Daniele
D
Pastori
Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.
Mariangela
0000-0002-9036-8495
M
Peruzzi
Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.
Elena
E
De Falco
Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.
Isotta
I
Chimenti
Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.
Giuseppe
G
Biondi-Zoccai
Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological, and Geriatric Sciences, Policlinico Umberto, Sapienza University of Rome, 00161 Rome, Italy.
Ernesto
E
Greco
Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.
Antonino G M
AG
Marullo
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00161 Rome, Italy.
Cristina
C
Nocella
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00161 Rome, Italy.
Francesco
F
Violi
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00161 Rome, Italy.
Pasquale
P
Pignatelli
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00161 Rome, Italy.
Camilla
C
Calvieri
Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy ; Department of AngioCardioNeurology, IRCCS NeuroMed, 86077 Pozzilli, Italy.
Giacomo
0000-0003-2703-3761
G
Frati
D052242:Adiponectin / Q000097:blood*; D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology*; D001281:Atrial Fibrillation / Q000097:blood*; D023201:CD40 Ligand / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015539:Platelet Activation; D012044:Regression Analysis; D012306:Risk; D012720:Severity of Illness Index; D016896:Treatment Outcome
D052242:Adiponectin; D000925:Anticoagulants; D023201:CD40 Ligand