Correlação entre níveis circulantes de Adiponectina e doença arterial coronária em pacientes submetidos à coronariografia eletiva

• Autor(a) principal: Souza, Rodrigo Almeida [UNIFESP]
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300000xb9s
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5001583; http://repositorio.unifesp.br/handle/11600/50259
• topic: Adiponectin; Coronary Artery Disease; Cardiac Catheterization; Atherosclerosis; Adiponectina; Doença Das Coronárias; Cateterismo Cardíaco; Aterosclerose

Adiponectin, an adipose tissue-released adipokine, coded by the gene whose polymorphisms are related to the presence of coronary artery disease (CAD), has demonstrated antiinflammatory and anti-atherogenic properties. Serum levels have shown an inverse relationship with the presence and complexity of CAD. Thus, we aimed to correlate total adiponectin levels (APN) and high molecular weight adiponectin (HMW) with the clinical presentation and extent of CAD in patients undergoing elective cardiac catheterization. From March 2008 to June 2010, 415 subjects undergoing cardiac catheterization at two tertiary centers who met inclusion criteria were enrolled. Patients with history of chronic kidney disease (creatinine clearance < 60 ml / min), active inflammation, cancer, coronary artery bypass surgery or thyroid disease were excluded. Clinical data, as well as blood sample for APN and HMW measurement were collected. Angiograms were reviewed by the researcher and a third observer, when discordant from official report. It was considered significant stenosis, obstruction > 70% in a major epicardial artery. Besides, CAD extent was estimated by the number of coronary arteries with significant stenosis and the Duke Jeopardy Score (DJS). Continuous variables were presented as mean ± SD or median with interquartile range. Differences between groups assessed by the Student t and Mann-Whitney tests. Categorical variables were presented as percentages, whose differences were analyzed by chi-square test and ANOVA. Significance level α < 0.05. In the final analysis, 224 subjects with obstructive CAD were divided into two groups according to CAD clinical presentation, stable or unstable. There was a predominance of males (62.5%), mean age 59.2 + 9.84 years. The groups were similar as other demographic, clinical, laboratory and angiographic. Serum APN (9,20 + 5,88 μg/mL vs 9,47 + 6,23 μg/mL; p = 0,738) and HMW (5,31 + 3,72 μg/mL vs 5,91 + 4,16 μg/mL; p = 0,255) were similar between groups with stable or unstable CAD, even after stratification by the number of arteries with obstructive disease, single vs multivessel (APN 9,39 + 5,76 μg/mL vs 9,26 + 6,27 μg/mL; p = 0,871 e HMW 5,29 + 3,79 μg/mL vs 5,83 + 4,04; p = 0,306) and the DJS score (APN, p = 0,72 / HMW0,21). Thus, we concluded that APN and HMW serum levels have no correlation with clinical presentation and extent of CAD in a high cardiovascular risk Brazilian population, despite these levels were significantly lower in the presence of obstructive CAD.