Carnevale Roberto, Pastori Daniele, Peruzzi Mariangela, De Falco Elena, Chimenti Isotta, Biondi-Zoccai Giuseppe, Greco Ernesto, Marullo Antonino G M, Nocella Cristina, Violi Francesco, Pignatelli Pasquale, Calvieri Camilla, Frati Giacomo
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00161 Rome, Italy.
Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.
Mediators Inflamm. 2014;2014:908901. doi: 10.1155/2014/908901. Epub 2014 Feb 26.
Adiponectin (APN) possesses anti-inflammatory and antiatherogenic effects. Atrial fibrillation (AF) is burdened by enhanced systemic inflammation and platelet activation, as documented by increased blood levels of soluble CD40L (sCD40L). The interplay between APN and platelet activation in AF is still undefined.
Circulating levels of APN and sCD40L were measured in 257 anticoagulated nonvalvular AF patients. Exclusion criteria were as follows: prosthetic heart valves, cardiac revascularization in the previous year, severe cognitive impairment, chronic infectious or autoimmune diseases, and active cancer.
Mean age was 72.9 (±8.7) years and 41.6% were female. Serum APN and plasmatic sCD40L were inversely correlated (R -0.626, P < 0.001). A progressive increase of sCD40L across tertiles of CHA2DS2-VASc score was observed (rS 0.473, P < 0.001), whilst APN was inversely correlated (rS -0.463, P < 0.001). A multivariable linear regression analysis showed that CHA2DS2-VASc score (B -0.227, P < 0.001) and sCD40L (B -0.524, P < 0.001) correlated to APN.
AF patients at high risk of stroke disclose low and high levels of APN and sCD40L, respectively, suggesting a role for APN if it favors platelet activation in vivo in this clinical setting. Enhancing APN levels may be a future goal to reduce the risk of vascular outcomes in AF patients.
脂联素（APN）具有抗炎和抗动脉粥样硬化作用。心房颤动（AF）存在全身炎症增强和血小板活化的情况，可溶性CD40配体（sCD40L）血液水平升高证明了这一点。AF中APN与血小板活化之间的相互作用仍不明确。
测定了257例接受抗凝治疗的非瓣膜性AF患者的循环中APN和sCD40L水平。排除标准如下：人工心脏瓣膜、前一年进行过心脏血运重建、严重认知障碍、慢性感染或自身免疫性疾病以及活动性癌症。
平均年龄为72.9（±8.7）岁，41.6%为女性。血清APN与血浆sCD40L呈负相关（R -0.626，P < 0.001）。观察到CHA2DS2-VASc评分三分位数中sCD40L逐渐升高（rS 0.473，P < 0.001），而APN呈负相关（rS -0.463，P < 0.001）。多变量线性回归分析显示，CHA2DS2-VASc评分（B -0.227，P < 0.001）和sCD40L（B -0.524，P < 0.001）与APN相关。
具有高卒中风险的AF患者分别表现出低水平和高水平的APN和sCD40L，这表明在这种临床情况下，如果APN在体内促进血小板活化，则其具有一定作用。提高APN水平可能是降低AF患者血管事件风险的未来目标。
