OBJECTIVE
To study the prognostic role of adipocytokines (apelin, omentin-1), reflecting the mechanisms of obesity in patients with coronary heart disease, to stratify the risk of adverse cardiovascular events during prospective follow-up.
MATERIALS AND METHODS
A prospective study enrolled 74 patients who underwent elective percutaneous coronary intervention at their first admission. In patients, anthropometric indicators were measured: waist circumference (WC) and hip circumference (HC); the WC/HC ratio and body mass index were also calculated. The concentration of apelin and omentin-1 was measured using an enzyme-linked immunosorbent assay. To assess the prognosis at 16 (9; 22) months, the following endpoints were analyzed: total and cardiovascular death, non-fatal myocardial infarction, non-fatal acute cerebrovascular accident, hospitalization for heart failure (HF) decompensation, unstable angina, and a composite endpoint including all of the listed adverse outcomes.
RESULTS
All patients were retrospectively divided into two groups: Group 1 included 47 patients with a favorable disease course, and Group 2 included 27 patients with adverse outcomes. Of the adverse outcomes, non-fatal myocardial infarction was the most common — 10.8% of patients, hospitalization due to HF decompensation and in-stent restenosis was 9.5% each, and 6.8% of patients had a fatal outcome. According to the results of the ROC analysis, the level of omentin-1 >12 ng/mL (p<0.0001), fibrinogen>2.82 g/L (p=0.24), a 6-minute walk distance ≤320 m (p=0.038) demonstrated high informative value and significance in assessing the risk of adverse events. The predictive value of apelin level (p=0.313) as a potential predictor of endpoint achievement was not confirmed. Multivariate regression analysis showed that only omentin-1 had prognostic value for the risk of adverse cardiovascular events.
CONCLUSION
Multivariate regression analysis showed that only omentin-1 had a high prognostic value for the risk of adverse cardiovascular events and, at a threshold of more than 12 ng/mL (p<0.0001), could be used as an additional prognostic factor in patients with coronary heart disease and abdominal obesity, including those who had percutaneous coronary intervention.
