Key result
Higher circulating adiponectin predicts ~34% greater 1-year MACCE risk after TAVI independent of visceral fat.
Why the study?
Clinical outcomes vary significantly after TAVI for severe aortic stenosis, and epicardial adipose tissue, visceral adipose tissue, and circulating adiponectin may contribute to this heterogeneity.
Do adipose tissue characteristics and circulating adiponectin levels predict 1-year MACCE in patients undergoing TAVI for severe aortic stenosis?
Cohort (n=243)
No
Do adipose tissue characteristics and circulating adiponectin levels predict 1-year MACCE in patients undergoing TAVI for severe aortic stenosis?
Effect estimate: HR 1.34 (95% CI 1.05-1.70)
p-value: p=0.017
Circulating adiponectin and visceral adipose tissue area independently predict 1-year MACCE after TAVI, while epicardial fat parameters require combination with adiponectin to be prognostically informative.
Higher adiponectin may refine post-TAVI MACCE risk stratification; leaves open causal role and need for prospective validation.
Background Transcatheter aortic valve implantation (TAVI) has become a standard treatment for severe aortic stenosis, yet clinical outcomes vary significantly. Epicardial adipose tissue (EAT), visceral adipose tissue (VAT), and circulating adiponectin may contribute to this heterogeneity. Aims To determine how adipose tissue characteristics, in combination with adiponectin levels, affect clinical outcomes following TAVI. Methods This single-center retrospective study included 243 patients with severe aortic stenosis who underwent TAVI. Pre-procedural computed tomography scans were processed using artificial intelligence to quantify EAT density (EATHU) and VAT area at the level of the L3 vertebra (VATL3A). Patients were stratified into groups based on median adiponectin (6.54 µg/mL), VATL3A (135 mm²), EATHU (-82.0 HU), and EATVOL (31 mL). The primary endpoint was 1-year major adverse cardiac and cerebrovascular events (MACCE), defined as all-cause mortality, heart failure hospitalization, or stroke. Results Over a mean follow-up of 344 ± 77 days, there were 25 deaths (10%), 12 heart failure hospitalizations (5%), and 7 strokes (3%). Circulating adiponectin (adjusted HR 1.34 per 5 μg/mL, 95% CI 1.05–1.70; p=0.017) and VATL3A (adjusted HR 0.63 per 100 mm², 95% CI 0.44–0.91; p=0.014) independently associated with MACCE, EATHU and EATVOL did not. All three combined adipose–adiponectin phenotypes demonstrated significant graded risk (p-for-trend 0.003–0.048), with the high EATVOL/high adiponectin phenotype showing the strongest association (adjusted HR 4.25, 95% CI 1.80–10.07). Conclusions Circulating adiponectin and VATL3A independently predict 1-year MACCE after TAVI. EAT parameters become prognostically informative only when combined with adiponectin.
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Storozhenko et al. (2026) conducted a cohort in Severe aortic stenosis (n=243). Circulating adiponectin and visceral adipose tissue (VATL3A) was evaluated on 1-year major adverse cardiac and cerebrovascular events (MACCE) (HR 1.34, 95% CI 1.05-1.70, p=0.017). Higher circulating adiponectin (HR 1.34; 95% CI 1.05-1.70) and lower visceral adipose tissue area (HR 0.63; 95% CI 0.44-0.91) independently predicted 1-year MACCE after TAVI.
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