AI Article Synopsis
- The study explored the impact of preoperative insulin resistance and adiponectin on outcomes in non-diabetic patients undergoing elective cardiac surgery.
- Adiponectin was linked to higher long-term mortality rates, particularly from 31 to 365 days post-surgery, while insulin resistance did not significantly predict adverse outcomes.
- The research suggests that measuring adiponectin could be valuable for assessing long-term risks in cardiac surgery patients, although further studies are needed to clarify its clinical usefulness.
Article Abstract
Background: Insulin resistance and adiponectin are markers of cardio-metabolic disease and associated with adverse cardiovascular outcomes. The present study examined whether preoperative insulin resistance or adiponectin were associated with short- and long-term adverse outcomes in non-diabetic patients undergoing elective cardiac surgery.
Methods: In a prospective study, we assessed insulin resistance and adiponectin levels from preoperative fasting blood samples in 836 patients undergoing cardiac surgery. Population-based medical registries were used for postoperative follow-up. Outcomes included all-cause death, myocardial infarction or percutaneous coronary intervention, stroke, re-exploration, renal failure, and infections. The ability of insulin resistance and adiponectin to predict clinical adverse outcomes was examined using receiver operating characteristics.
Results: Neither insulin resistance nor adiponectin were statistically significantly associated with 30-day mortality, but adiponectin was associated with an increased 31-365-day mortality (adjusted odds ratio 2.9 [95% confidence interval 1.3-6.4]) comparing the upper quartile with the three lower quartiles. Insulin resistance was a poor predictor of adverse outcomes. In contrast, the predictive accuracy of adiponectin (area under curve 0.75 [95% confidence interval 0.65-0.85]) was similar to that of the EuroSCORE (area under curve 0.75 [95% confidence interval 0.67-0.83]) and a model including adiponectin and the EuroSCORE had an area under curve of 0.78 [95% confidence interval 0.68-0.88] concerning 31-365-day mortality.
Conclusions: Elevated adiponectin levels, but not insulin resistance, were associated with increased mortality and appear to be a strong predictor of long-term mortality. Additional studies are warranted to further clarify the possible clinical role of adiponectin assessment in cardiac surgery.
Trial Registration: The Danish Data Protection Agency; reference no. 2007-41-1514.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3009968 | PMC |
| http://dx.doi.org/10.1186/1749-8090-5-129 | DOI Listing |
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