Differential prognostic value of resistin for cardiovascular death in patients with stable coronary artery disease according to the presence of metabolic syndrome

Abstract

Abstract Background Resistin is associated with atherosclerosis progression by affecting inflammation and insulin resistance. There are controversial data regarding the prognostic value of resistin in patients with coronary artery disease (CAD). Purpose We prospectively investigated the long-term prognostic value of resistin in patients with stable CAD. Methods A total 741 consecutive patients with stable CAD were followed for a median of 5.5 years. Serum resistin, lipids, high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) levels were measured at baseline. Primary endpoints were cardiac death (CD) and secondary hospitalizations for acute coronary syndrome, arrhythmic event or stroke. Results Follow-up data were obtained from 703 patients of whom 79 had a CD (11.2%) and 205 (29.2%) met the secondary endpoints. Resistin was positively correlated with hsCRP (r=0.159, p<0.001) and IL-6 (r=0.165, p=0.002), and negatively with HDL-cholesterol (r=−0.176, p<0.001). Resistin levels could not predict CD [HR: 1.044; 95% CI: 0.994 to 1.096; p=0.087] neither secondary endpoints [HR: 1.025; 95% CI: 0.983 to 1.068; p=0.250). Among 298 patients (42.4%) with metabolic syndrome (MS) resistin levels were independent predictors of CD after adjustment for conventional risk factors and left ventricular ejection fraction (LVEF) [HR: 1.145; 95% CI: 1.057 to 1.240; p=0.001]. Patients with resistin values ≥7.6 ng/mL (median level) had 2.8 times higher risk of CD compared to those with resistin levels <7.6 ng/mL after adjustment for traditional risk factors and LVEF (HR: 2.882; 95% CI: 1.311 to 6.336; p=0.008). Conclusions Resistin is an independent long-term predictor of CD in patients with stable CAD and MS. Funding Acknowledgement Type of funding sources: None. Figure 1