Baseline epicardial adipose tissue adiponectin levels predict cardiovascular outcomes: a long-term follow-up study.

Objective: Epicardial adipose tissue (EAT) produces a wide range of adipokines and has recently been linked to the physiopathology of cardiovascular (CV) and metabolic diseases. We aimed to study whether EAT and subcutaneous (SAT) adiponectin and leptin expression levels are associated with CV complications during long-term follow-up.

Methods And Results: EAT and SAT samples were obtained during surgery - mainly CABG (n=77) - from 137 patients (mean age 69.9 years, 31% women). Adiponectin and leptin mRNA levels were analyzed by RT-PCR. Plasma adiponectin levels were determined in a subsample of subjects (n=43). Thirty-four patients developed CV complications during 41 (SD 23) months of mean follow-up. Patients with CV events had lower EAT and SAT adiponectin levels at baseline (12.4 (3.0) vs. 15.7 (3.8) a.u., P=0.001; and 13.7 (2.6) vs. 15.7 (4.4) a.u., P=0.048, respectively). However, baseline EAT and SAT leptin levels and plasma adiponectin levels were not significantly different between patients with/without CV events during follow-up. Cox proportional hazards models adjusting for covariates in stages revealed that only baseline EAT adiponectin levels and heart failure could predict CV events.

Conclusions: EAT adiponectin levels are strong predictors of CV prognosis in patients with CV diseases. EAT is likely to play a major role in the development of CV complications mainly through local effects.