Association of serum adiponectin levels and coronary flow reserve in women with normal coronary angiography

Eroğlu, Serpil; Sade, Leyla Elif; Bozbaş, Hüseyin; Haberal, A; Özbiçer, Süleyman; Demir, Özlem; Müderrisoğlu, Haldun

doi:10.1097/hjr.0b013e32831f1b8a

Cited by 22 publications

(18 citation statements)

References 36 publications

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“…CMF after STEMI is important for the clinical outcome independently of epicardial flow [ 50 ]. Although the inverse relationship between HOMA index and CFR was described in different states [ 51 - 53 ], to the best of our knowledge the current study is the first to link acute IR assessed by the HOMA index and CFR in non-diabetic STEMI patients. Acute hyperglycemia per se predicted impaired epicardial flow before pPCI [ 54 ] and impaired CMF after pPCI in unselected, mixed diabetic and non-diabetic patients [ 55 ].…”

Section: Discussionmentioning

confidence: 82%

Acute insulin resistance in ST-segment elevation myocardial infarction in non-diabetic patients is associated with incomplete myocardial reperfusion and impaired coronary microcirculatory function

Trifunović

Stanković

Šobić-Šaranović

et al. 2014

Cardiovasc Diabetol

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BackgroundInsulin resistance (IR) assessed by the Homeostatic Model Assessment (HOMA) index in the acute phase of myocardial infarction in non-diabetic patients was recently established as an independent predictor of intrahospital mortality. In this study we postulated that acute IR is a dynamic phenomenon associated with the development of myocardial and microvascular injury and larger final infarct size in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (pPCI).MethodsIn 104 consecutive patients with the first anterior STEMI without diabetes, the HOMA index was determined on the 2nd and 7th day after pPCI. Worst-lead residual ST-segment elevation (ST-E) on postprocedural ECG, coronary flow reserve (CFR) determined by transthoracic Doppler echocardiography on the 2nd day after pPCI and fixed perfusion defect on single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) determined six weeks after pPCI were analyzed according to HOMA indices.ResultsIR was present in 55 % and 58 % of patients on day 2 and day 7, respectively. Incomplete post-procedural ST-E resolution was more frequent in patients with IR compared to patients without IR, both on day 2 (p = 0.001) and day 7 (p < 0.001). The HOMA index on day 7 correlated with SPECT-MPI perfusion defect (r = 0.331), whereas both HOMA indices correlated well with CFR (r = -0.331 to -0.386) (p < 0.01 for all). In multivariable backward logistic regression analysis adjusted for significant univariate predictors and potential confounding variables, IR on day 2 was an independent predictor of residual ST-E ≥ 2 mm (OR 11.70, 95% CI 2.46-55.51, p = 0.002) and CFR < 2 (OR = 5.98, 95% CI 1.88-19.03, p = 0.002), whereas IR on day 7 was an independent predictor of SPECT-MPI perfusion defect > 20% (OR 11.37, 95% CI 1.34-96.21, p = 0.026).ConclusionIR assessed by the HOMA index during the acute phase of the first anterior STEMI in patients without diabetes treated by pPCI is independently associated with poorer myocardial reperfusion, impaired coronary microcirculatory function and potentially with larger final infarct size.

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Section: Discussionmentioning

confidence: 82%

Acute insulin resistance in ST-segment elevation myocardial infarction in non-diabetic patients is associated with incomplete myocardial reperfusion and impaired coronary microcirculatory function

Trifunović

Stanković

Šobić-Šaranović

et al. 2014

Cardiovasc Diabetol

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“…Decreased serum adiponectin levels and impaired CFR occur in women with “normal” epicardial coronary arteries. 72 Insulin-resistance is strongly associated with both microvascular and macrovascular coronary disorders, and confers high risk for CVD morbidity and mortality (women > men). 4, 73 Coronary microvascular abnormalities are highly prevalent and worsen with progressive glucose intolerance with or without obstructive CAD, and non-obstructive CAD is highly prevalent in those with diabetes.…”

Section: Pathophysiologymentioning

confidence: 99%

Ischemia and No Obstructive Coronary Artery Disease (INOCA)

Merz¹,

Pepine²,

Walsh³

et al. 2017

Circulation

575

249

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The Cardiovascular Disease in Women Committee of the American College of Cardiology, in conjunction with interested parties (from the National Heart, Lung, and Blood Institute, American Heart Association, European Society of Cardiology), convened a working group to develop a consensus on the syndrome of myocardial ischemia with no obstructive coronary arteries (INOCA). In general, these patients have elevated risk for a cardiovascular event (including acute coronary syndrome, heart failure hospitalization, stroke, and repeated cardiovascular procedures) vs reference subjects, and appear to be at higher risk for development of heart failure with preserved ejection fraction (HFpEF). A subgroup of these patients also has coronary microvascular dysfunction (CMD) and evidence of inflammation. This document provides a summary of findings and recommendations toward the development of an integrated approach for identifying and managing patients with INOCA, and outlining knowledge gaps in the area. Working group members critically reviewed available literature and current practices for risk assessment and state-of-the-science techniques in multiple areas, with a focus on next steps needed to develop evidence-based therapies. This report presents highlights of this working group review and a summary of suggested research directions to advance this field in the next decade.

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“…28 Low adiponectin levels were associated with impaired CFR in women with a normal coronary angiography and were an independent predictor of impaired CFR. 29 The significant increase in adiponectin concentration in this study, which decreased inflammatory cytokines and interferes with TNF-α signaling, from baseline might have contributed to the greater restoration of microvascular integrity after acute ischemic injury in that group. 30 The effect was also seen for cytokineactivated products such as the soluble proteins IL-6 involved in either the amplification of the inflammatory response or specific chemoattraction for granulocytes.…”

Section: Discussionmentioning

confidence: 99%

Correlation Between Circulating Angiogenic Cell Mobilizations and Recovery of Coronary Flow Reserve in Patients With Acute Myocardial Infarction

Jeong

Hong

Park

et al. 2012

Circ J

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Association of serum adiponectin levels and coronary flow reserve in women with normal coronary angiography

Abstract: Decreased adiponectin levels are associated with impaired CFR in women with normal epicardial coronary arteries and hypoadiponectinemia may be a risk factor for impaired CFR in women.

Cited by 22 publications

References 36 publications

Acute insulin resistance in ST-segment elevation myocardial infarction in non-diabetic patients is associated with incomplete myocardial reperfusion and impaired coronary microcirculatory function

Acute insulin resistance in ST-segment elevation myocardial infarction in non-diabetic patients is associated with incomplete myocardial reperfusion and impaired coronary microcirculatory function

Ischemia and No Obstructive Coronary Artery Disease (INOCA)

Correlation Between Circulating Angiogenic Cell Mobilizations and Recovery of Coronary Flow Reserve in Patients With Acute Myocardial Infarction

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