title: Circulating irisin levels and coronary heart disease: association with future acute coronary syndrome and major adverse cardiovascular events.
abstract: BACKGROUND
  Irisin is a newly discovered myokine, associated with 'browning' of the white adipose tissue, obesity, insulin resistance and metabolic syndrome. The purpose of this study is to evaluate circulating irisin as a predictor of acute coronary syndromes (ACSs) and major adverse cardiovascular events (MACE).
  
  
  METHODS
  Sub-study 1: a case-control study, nested within the Veteran's Affairs Normative Ageing Study, evaluating circulating irisin levels in 88 ACS cases and 158 age- and sampling year-matched controls, as a predictor of ACS. Sub-study 2: a prospective cohort study, where 103 participants with established coronary artery disease were stratified by circulating irisin levels at the time they received percutaneous coronary interventions (PCIs) and were followed for the development of MACE.
  
  
  RESULTS
  Study 1: there was no association between irisin levels and ACS in otherwise healthy individuals (odds ratio: 1.00 95% confidence interval: (0.99-1.00)). Study 2: the incidence of MACE was significantly lower in the first irisin tertile compared with the second and third (incidence rate 0 vs 0.92 (0.51-1.61) vs 0.57 (0.28-1.14) events per 1000 person-days; P < 0.01). This was primarily driven by the lower incidence of unstable angina (incidence rate 0 vs 0.61 (0.31-1.22) vs 0.43 (0.19-0.96) per 1000 person-days; P = 0.01).
  
  
  CONCLUSIONS
  This is the first study to date that demonstrates that, although circulating irisin levels do not predict the development of ACS in healthy individuals, increased irisin levels are associated with the development of MACE in patients with established coronary artery disease after PCI.
authors.affiliation: 1] Section of Endocrinology, Department of Medicine, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA [2] Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA [3] Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
authors.forename: K N
authors.identifier: 0000000171898434
authors.initials: KN
authors.lastname: Aronis
authors.affiliation: Department of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomèdica de Girona (IdIBGi), CIBEROBN (CB06/03/010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Moreno
authors.affiliation: Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration General Hospital, Thessaloniki, Greece.
authors.forename: S A
authors.initials: SA
authors.lastname: Polyzos
authors.affiliation: Department of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomèdica de Girona (IdIBGi), CIBEROBN (CB06/03/010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Moreno-Navarrete
authors.affiliation: Department of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomèdica de Girona (IdIBGi), CIBEROBN (CB06/03/010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain.
authors.forename: W
authors.initials: W
authors.lastname: Ricart
authors.affiliation: Central Hospital of Asturias, Oviedo, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Delgado
authors.affiliation: Central Hospital of Asturias, Oviedo, Spain.
authors.forename: J
authors.initials: J
authors.lastname: de la Hera
authors.affiliation: 1] Section of Endocrinology, Department of Medicine, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA [2] Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Sahin-Efe
authors.affiliation: 1] Section of Endocrinology, Department of Medicine, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA [2] Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Chamberland
authors.affiliation: 1] Section of Endocrinology, Department of Medicine, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA [2] Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Berman
authors.affiliation: Normative Aging Study, VA Boston Healthcare System and Boston University Schools of Public Health and Medicine, Boston, MA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Spiro
authors.affiliation: Normative Aging Study, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA.
authors.forename: P
authors.initials: P
authors.lastname: Vokonas
authors.affiliation: Central Hospital of Asturias, Oviedo, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández-Real
authors.affiliation: 1] Section of Endocrinology, Department of Medicine, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA [2] Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Mantzoros
mesh_terms: D054058:Acute Coronary Syndrome / Q000378:metabolism* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D005353:Fibronectins / Q000378:metabolism*; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism* / Q000503:physiopathology; D047495:PPAR gamma / Q000378:metabolism; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: C577593:FNDC5 protein, human; D005353:Fibronectins; D047495:PPAR gamma