title: Elevated levels of adipokines predict outcome after acute myocardial infarction: A long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort.
abstract: Adiponectin and leptin are associated with insulin resistance and cardiovascular disease. Information on the prognostic value after an acute myocardial infarction is still conflicting.
  
  
  
  Patients (n = 180) without known diabetes and with admission glucose of <11 mmol/L admitted for an acute myocardial infarction in 1998-2000 were followed for mortality and cardiovascular events (first of cardiovascular mortality/acute myocardial infarction/stroke/heart failure) until the end of 2011 (median: 11.6 years). Plasma adiponectin and leptin were related to outcome in Cox proportional-hazard regression analyses.
  
  
  
  Median age was 64 years and 69% were male. Total mortality was 34% (n = 61) and 44% (n = 80) experienced a cardiovascular event. Adiponectin at discharge predicted cardiovascular events (hazard ratio; 95% confidence interval; 1.45; 1.02-2.07, p = 0.038), total mortality (2.53; 1.64-3.91, p < 0.001) and cancer mortality (3.64; 1.51-8.74, p = 0.004). After adjustment for age, sex, body mass index, previous myocardial infarction and heart failure, adiponectin predicted total mortality (1.79; 1.07-3.00, p = 0.027) but not cardiovascular events. High levels of leptin were associated with cardiovascular events during the first 7 years, after which the association was attenuated. Leptin did not predict total mortality.
  
  
  
  In patients with acute myocardial infarction but without previously known diabetes, high levels of adiponectin at discharge predicted total mortality. The present results support the hypothesis that high rather than low levels of adiponectin predict mortality after acute myocardial infarction.
authors.affiliation: 1 Unit of Cardiology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.|2 Department of Research and Development, Region Kronoberg, Växjö, Sweden.
authors.forename: Viveca
authors.initials: V
authors.lastname: Ritsinger
authors.affiliation: 3 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.|4 Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital Solna, Stockholm, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Brismar
authors.affiliation: 1 Unit of Cardiology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Klas
authors.initials: K
authors.lastname: Malmberg
authors.affiliation: 1 Unit of Cardiology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Linda
authors.initials: L
authors.lastname: Mellbin
authors.affiliation: 5 Centre for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Näsman
authors.affiliation: 1 Unit of Cardiology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Rydén
authors.affiliation: 6 Department of Public Health and Clinical Medicine/Cardiology, Umeå University, Umeå, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Söderberg
authors.affiliation: 7 Department of Medicine and Centre for Clinical Research, Västerås Central Hospital, Västerås, Sweden.
authors.forename: Åke
authors.initials: Å
authors.lastname: Tenerz
authors.affiliation: 1 Unit of Cardiology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.|8 Capio St Göran's Hospital, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Norhammar
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002423:Cause of Death; D016009:Chi-Square Distribution; D005260:Female; D018149:Glucose Intolerance / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D007333:Insulin Resistance; D053208:Kaplan-Meier Estimate; D020738:Leptin / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D016017:Odds Ratio; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D013548:Sweden; D013997:Time Factors
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D001786:Blood Glucose; D020738:Leptin
keywords: Acute myocardial infarction; adipokines; diabetes; prognosis