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Total adiponectin is associated with incident cardiovascular and renal events in treated hypertensive patients: subanalysis of the ATTEMPT-CVD randomized trial - PubMed

  • ️Tue Jan 01 2019

Randomized Controlled Trial

Total adiponectin is associated with incident cardiovascular and renal events in treated hypertensive patients: subanalysis of the ATTEMPT-CVD randomized trial

Shokei Kim-Mitsuyama et al. Sci Rep. 2019.

Abstract

The predictive value of serum adiponectin for hypertensive cardiovascular outcomes is unknown. This study was performed to investigate the association of adiponectin with incident cardiovascular and renal events (CV events) in hypertensive patients. We performed post-hoc analysis on 1,228 hypertensive patients enrolled in the ATTEMPT-CVD study, a prospective randomized study comparing the effects of two antihypertensive therapies. The participants were divided into quartiles of baseline serum total adiponectin or high molecular weight (HMW) adiponectin. Multivariable Cox proportional hazards analysis was performed to determine the prognostic factors associated with CV events. Kaplan-Meier analysis for CV events by quartiles of baseline total adiponectin showed that patients in the highest total adiponectin quartile (Q4) had more CV events (P = 0.0135). On the other hand, no significant difference was noted regarding the incidence of CV events among patients stratified by HMW adiponectin quartile (P = 0.2551). Even after adjustment for potential confounders, the highest total adiponectin quartile (Q4) remained independently associated with incident CV events in hypertensive patients (HR = 1.949: 95%CI 1.051-3.612; P = 0.0341). These results showed that total adiponectin, but not HMW adiponectin, was independently associated with the incidence of CV events in treated hypertensive patients, thereby highlighting total adiponectin as a valuable predictor for hypertensive cardiovascular outcomes.

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Conflict of interest statement

Shokei Kim-Mitsuyama has received consultancy fees/honoraria/research grant from Astellas, Daiichi-Sankyo, and Takeda. Osamu Yasuda has received consultancy fees/honoraria/research grant from Otsuka Pharmaceutical Co., Ltd and Sanwa Kagaku Kenkyusho Co., Ltd. Koichi Node has received consultancy fees/honoraria/research grant from Boerhinger Ingelheim. Hideaki Jinnouchi has received consultancy fees/honoraria/research grant from AstraZeneca Pharmaceuticals, Astellas Pharma, Boehringer Ingelheim, Daiichi-sankyo, Eli Lilly, Takeda, Novartis Pharmaceuticals, Novo Nordisk and Sanofi. Kunihiko Matsui has received consultancy fees/honoraria/research grant from Daiici-Sankyo, Japan Boehringer-Ingelheim. All other coauthors declare that they have no financial competing interests. All authors declare that they have no non-financial competing interests.

Figures

Figure 1
Figure 1

Kaplan-Meier curves for composite cardiovascular and renal events stratified by quartiles of serum total adiponectin at baseline. The number of occurrence of endpoints was 17, 18, 19, and 35 in Q1 (n = 306), Q2 (n = 302), Q3 (n = 303), and Q4 (n = 302), respectively.

Figure 2
Figure 2

Kaplan-Meier curves for composite cardiovascular and renal events stratified by quartiles of serum HMW adiponectin (A) or by quartiles of HMW/total adiponectin ratio (B). (A) The number of occurrence of endpoints was 18, 19, 22, and 30 in Q1 (n = 306), Q2 (n = 303), Q3 (n = 301), and Q4 (n = 303), respectively. (B) The number of occurrence of endpoints was 18, 21, 25, and 25 in Q1 (n = 306), Q2 (n = 303), Q3 (n = 300), and Q4 (n = 304), respectively.

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