January 1, 2019Brazilian Journal of Medical and Biological ResearchOpen Access

Association between elevated adiponectin level and adverse outcomes in patients with heart failure: a systematic review and meta-analysis

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Why the study?

Studies regarding the prognostic value of circulating adiponectin levels in patients with heart failure have yielded conflicting results.

Does higher circulating adiponectin level predict increased risk of mortality and readmission in patients with heart failure?

Structured PICO

Does higher circulating adiponectin level predict increased risk of mortality and readmission in patients with heart failure?

Population

7 observational studies involving 862 patients with heart failure

Intervention

Higher circulating adiponectin level

Comparator

Lower circulating adiponectin level

Outcome

All-cause mortalityhard clinical

Elevated baseline circulating adiponectin levels are associated with an increased risk of all-cause mortality and death/readmission in patients with heart failure, suggesting its potential utility for risk stratification.

Implication

Supports adiponectin for HF risk stratification; extends meta-analytic evidence but remains hypothesis-generating for practice.

Abstract

Studies regarding the prognostic value of circulating adiponectin level in patients with heart failure are conflicting. The aim of this meta-analysis was to evaluate the association between elevated circulating adiponectin level and adverse outcomes in patients with heart failure. We searched PubMed and Embase databases from their inception to June 2018. Original observational studies that investigated the prognostic value of adiponectin in heart failure patients and reported all-cause mortality or combined endpoints of death/readmission as outcome measure were included. Pooled risk ratio (RR) with 95% confidence intervals (CI) were estimated by higher versus lower circulating adiponectin level. A total of 7 studies involving 862 heart failure patients were identified. Meta-analysis showed that heart failure patients with higher adiponectin level had significantly increased risk of all-cause mortality (RR 2.05; 95%CI 1.22-3.43) after adjustment for potential confounders. In addition, higher adiponectin level was associated with an increased risk of the combined endpoints of death/readmission (RR 2.22; 95%CI 1.38-3.57). Elevated baseline circulating adiponectin level is possibly associated with an increased risk of all-cause mortality and the combined endpoints of death/readmission in patients with heart failure. Determination of circulating adiponectin level has potential to improve risk stratification in heart failure patients.