Low Plasma Adiponectin Levels Are Associated With Vulnerable Plaque Features in Patients With Acute Coronary Syndrome: An Optical Coherence Tomography Study

Background: Vulnerable plaques are the primary cause of acute coronary syndrome (ACS). The association between in-vivo plaque vulnerability and adiponectin levels in ACS still remains to be determined. Objective: The purpose of this study was to investigate the correlation between adiponectin levels and vulnerable plaque features in ACS patients. Methods: We enrolled 107 ACS patients admitted to our institution; 83 with Non-ST elevation ACS (NSTE-ACS) and 24 with ST-elevation myocardial infarction (STEMI). Adiponectin levels were measured in these patients. Coronary angiography and subsequent optical coherence tomography (OCT) analysis of culprit lesions were performed. Results: Adiponectin level was lower in patients with complex angiographic lesions, compared to those with non-complex lesions (7.13 +/- 3.04 vs. 8.94 +/- 2.84 mu g/ml, P = 0.002). Adiponectin level was lower in patients with plaque rupture (PR), micro-thrombi, and thin cap fibroatheroma (TCFA), compared to those with non-vulnerable features (7.19 +/- 2.95 vs 8.79 +/- 3.02 mu g/ml, P = 0.007 & 7.29 +/- 2.97 vs 8.44 +/- 3.09 mu g/ml, P = 0.04 and 4.76 +/- 0.65 vs 9.74 +/- 2.35 mu g/ml, P < 0.001 mu g/ml respectively). There was a significant negative correlation between adiponectin levels and lipid rich plaque extent and maximum lipid arc (r = -0.05, P < 0.001 & r=-0.03, P=0.03, respectively). However, a significant positive correlation was observed between adiponectin levels and fibrous cap thickness (r=0.95, P < 0.001). Conclusion: Low adiponectin levels were associated with complex angiographic lesions and vulnerable plaque features in ACS patients, where there was a significant correlation between it and PR, TCFA, and lipid rich plaque. (C) 2020 Elsevier Inc. All rights reserved.