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Adiponectina plasmática, índice de masa corporal y mortalidad en pacientes con insuficiencia cardíaca crónica
Caroline Kistorp1, Jens Faber, Søren Galatius
1Department of Cardiology and Endocrinology, Frederiksberg University Hospital, Copenhagen, Denmark. cnkistorp@dadlnet.dk
Circulation
|September 15, 2005
Resumen
Los altos niveles de adiponectina predicen la mortalidad en pacientes con insuficiencia cardíaca crónica (ICC), independientemente de la gravedad de la enfermedad. El índice de masa corporal (IMC) también predice la mortalidad, potencialmente mediada por los niveles de adiponectina y NT-proBNP.
Área de la Ciencia:
- Cardiología Cardiología.
- Endocrinología Endocrinología.
- El síndrome metabólico.
Sus antecedentes:
- Un mayor índice de masa corporal (IMC) está relacionado con un mejor pronóstico de insuficiencia cardíaca crónica (ICC).
- La adiponectina, una adipocitocina inversamente asociada con el IMC, es un predictor de mortalidad en individuos sanos.
- La relación entre la adiponectina y la mortalidad en pacientes con CHF requiere más investigación.
Objetivo del estudio:
- Investigar la asociación entre los niveles plasmáticos de adiponectina y la mortalidad en pacientes con insuficiencia cardíaca crónica (ICC).
Principales métodos:
- Estudio prospectivo en el que participaron 195 pacientes con FHC.
- Las mediciones basales incluyeron adiponectina plasmática, péptido natriurético procerebral N-terminal (NT-proBNP) y IMC.
- Datos de mortalidad recopilados durante un seguimiento mediano de 2,6 años.
Principales resultados:
- La adiponectina y el NT-proBNP se asociaron positivamente entre sí y se asociaron negativamente con el IMC.
- Los altos niveles de adiponectina (tertiles superiores) predijeron la mortalidad, incluso después de ajustar los marcadores de gravedad de la ECH y el NT-proBNP (HR = 3,23, P = 0,032).
- El IMC predijo la mortalidad independientemente de la gravedad de la insuficiencia cardíaca congestiva, pero perdió importancia después de ajustar por NT-proBNP (HR = 0.74, P = 0.13).
Conclusiones:
- Los niveles elevados de adiponectina son un predictor independiente de la mortalidad en pacientes con ECH, lo que posiblemente indica desfallecimiento.
- La asociación entre el IMC y la mortalidad en CHF puede estar mediada en parte por la adiponectina y el NT-proBNP.
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