Clinical Investigation
Association of Resistin With Heart Failure and Mortality in Patients With Stable Coronary Heart Disease: Data From the Heart and Soul Study

https://doi.org/10.1016/j.cardfail.2010.08.007Get rights and content

Abstract

Background

Resistin is a pro-inflammatory signaling molecule that is thought to contribute to atherosclerosis. We sought to evaluate whether resistin is predictive of worse cardiovascular outcomes among ambulatory patients with stable coronary heart disease (CHD).

Methods and Results

We measured baseline serum resistin in 980 participants with documented CHD. After a mean follow-up of 6.1 (range, 0.1 to 9.0) years, 358 (36.5%) were hospitalized for myocardial infarction or heart failure or had died. As compared with participants who had resistin levels in the lowest quartile, those with resistin levels in the highest quartile were at an increased risk of heart failure (hazard ratio [HR], 2.06; 95% confidence interval [CI], 1.26–3.39) and death (HR, 1.56; 95% CI, 1.11–2.18), adjusted for age, sex, and race. Further adjustments for obesity, hypertension, insulin resistance, dyslipidemia, and renal dysfunction eliminated these associations. Resistin levels were not associated with an increased risk of non-fatal myocardial infarction (unadjusted HR, 1.18; 95% CI, 0.68-2.05).

Conclusions

Elevated serum resistin is associated with higher rates of mortality and hospitalization for heart failure. However, this appears to be explained by the association of resistin with traditional measures of cardiovascular risk. Thus, serum resistin does not add prognostic information among high-risk persons with established CHD.

Section snippets

Study Participants

The Heart and Soul study is a prospective cohort study designed to evaluate the effect of psychosocial factors on CHD progression and health outcomes. Methods have been described previously.17, 18 We used administrative databases to identify outpatients with documented CHD at 2 Veterans Affairs Medical Centers, 1 university hospital, and 9 public health clinics in San Francisco Bay Area. Eligible patients had at least 1 of the following: myocardial infarction, coronary revascularization,

Results

The median resistin level among the 980 participants was 8.51 ng/mL (interquartile range, 5.79–12.21 ng/mL). Compared with those in the lowest resistin quartile (<5.78 ng/mL), those in the highest quartile (>12.24 ng/mL) were older and more likely to be white. They were more likely to have a history of congestive heart failure and to be taking a diuretic. They had lower eGFR and higher fasting glucose, glycosylated hemoglobin, and systolic and diastolic blood pressures but similar cardiac

Discussion

In the present study, we found that elevated serum resistin levels predict all-cause mortality and hospitalization for heart failure in a high-risk cohort with established CHD. However, consistent with other studies, participants in our cohort with the highest resistin concentrations were also more likely to have clinical risk factors for poor cardiovascular outcomes, including higher fasting glucose and glycosylated hemoglobin, elevated blood pressure, and worse renal function.13, 14, 21, 22

Disclosures

None.

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      High leptin levels are considered independent risk factor for acute cardiovascular events, since predisposes to NO downregulation and atherogenesis [66]. Cardiovascular diseases are also associated to high resistin levels in ESRD patients [67], which may indicate increased risk for heart failure and sudden death [68]. In addition, leptin and resistin are antagonized by adiponectin, which exerts anti-inflammatory and cardiovascular protective effects [69].

    • Resistin as a predictor of cardiovascular hospital admissions and renal deterioration in diabetic patients with chronic kidney disease

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      Moreover, resistin levels predict adverse cardiovascular events in patients with coronary artery disease, including those who were submitted to coronary artery stenting.51 In addition, a recent study demonstrated a relation between resistin levels and hospitalization for heart failure in patients already diagnosed with coronary heart disease,52 which is in line with our findings. A previous study on a Japanese population demonstrated that serum resistin levels were important for the progression of CKD after adjusting for confounding factors and the mean values of resistin were higher even in early stages of CKD.53

    • Resistin: A reappraisal

      2019, Mechanisms of Ageing and Development
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      Although in several initial studies, a positive correlation between resistin levels and obesity or IR was reported (Degawa-Yamauchi et al., 2003; Azuma et al., 2003), other groups failed to identify changes in resistin levels either in obesity, IR, or DM2 (Lee et al., 2003; Amirhakimi et al., 2011). Clinical studies investigating whether plasma resistin is a predictor for coronary heart disease (CHD) and cardiovascular mortality yielded conflicting results (Yaturu et al., 2006a; Burnett et al., 2005; Ohmori et al., 2005; Pischon et al., 2005; Efstathiou et al., 2007; Lubos et al., 2007; Pilz et al., 2007; Lee et al., 2009b; Zhang et al., 2011; Menzaghi et al., 2014; Spoto et al., 2013). In several studies, resistin was shown a major cause of atherosclerosis (ATS) and related CVD (Burnett et al., 2005; Reilly et al., 2005; Langheim et al., 2010; Pischon et al., 2005; Ohmori et al., 2005; Tsukahara et al., 2009), including heart failure (HF) (Cheng et al., 2013) and cardiac ischemic events (Filková et al., 2009; Jamaluddin et al., 2012).

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    Supported by grants from the American Federation for Aging Research (M.H.Z., M.A.W.), the American Heart Association (M.H.Z.), the Philanthropic Educational Organization Scholars Program (M.H.Z.), the Department of Veterans Affairs, the National Heart, Lung and Blood Institute, the Robert Wood Johnson Foundation, the Ischemia Research and Education Foundation, and the Nancy Kirwan Heart Research Fund. None of these funding sources had any role in design, analysis, or preparation of the manuscript.

    See page 29 for disclosure information.

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