Pericoronary fat inflammation and Major Adverse Cardiac Events (MACE) in prediabetic patients with acute myocardial infarction: effects of metformin.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101147637 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-2840 (Electronic) Linking ISSN: 14752840 NLM ISO Abbreviation: Cardiovasc Diabetol Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2002-
    • Subject Terms:
      Coronary Artery Bypass*/adverse effects; Adipose Tissue/*drug effects ; Hypoglycemic Agents/*therapeutic use ; Inflammation Mediators/*metabolism ; Metformin/*therapeutic use ; Myocardial Infarction/*surgery ; Prediabetic State/*drug therapy; Adiponectin/metabolism ; Adipose Tissue/metabolism ; Aged ; Biomarkers/metabolism ; Female ; Humans ; Hypoglycemic Agents/adverse effects ; Italy/epidemiology ; Leptin/metabolism ; Male ; Metformin/adverse effects ; Middle Aged ; Myocardial Infarction/diagnostic imaging ; Myocardial Infarction/epidemiology ; Myocardial Infarction/metabolism ; Prediabetic State/diagnosis ; Prediabetic State/epidemiology ; Prediabetic State/metabolism ; Prospective Studies ; Risk Factors ; Sirtuins/metabolism ; Time Factors ; Treatment Outcome ; Tumor Necrosis Factor-alpha/metabolism
    • Abstract:
      Background/objectives: Pericoronary adipose tissue inflammation might lead to the development and destabilization of coronary plaques in prediabetic patients. Here, we evaluated inflammation and leptin to adiponectin ratio in pericoronary fat from patients subjected to coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI). Furthermore, we compared the 12-month prognosis of prediabetic patients compared to normoglycemic patients (NG). Finally, the effect of metformin therapy on pericoronary fat inflammation and 12-months prognosis in AMI-prediabetic patients was also evaluated.
      Methods: An observational prospective study was conducted on patients with first AMI referred for CABG. Participants were divided in prediabetic and NG-patients. Prediabetic patients were divided in two groups; never-metformin-users and current-metformin-users receiving metformin therapy for almost 6 months before CABG. During the by-pass procedure on epicardial coronary portion, the pericoronary fat was removed from the surrounding stenosis area. The primary endpoints were the assessments of Major-Adverse-Cardiac-Events (MACE) at 12-month follow-up. Moreover, inflammatory tone was evaluated by measuring pericoronary fat levels of tumor necrosis factor-α (TNF-α), sirtuin 6 (SIRT6), and leptin to adiponectin ratio. Finally, inflammatory tone was correlated to the MACE during the 12-months follow-up.
      Results: The MACE was 9.1% in all prediabetic patients and 3% in NG-patients. In prediabetic patients, current-metformin-users presented a significantly lower rate of MACE compared to prediabetic patients never-metformin-users. In addition, prediabetic patients showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to NG-patients (P < 0.001). Prediabetic never-metformin-users showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to current-metformin-users (P < 0.001). Remarkably, inflammatory tone and leptin to adiponectin ratio was significantly related to the MACE during the 12-months follow-up.
      Conclusion: Prediabetes increase inflammatory burden in pericoronary adipose tissue. Metformin by reducing inflammatory tone and leptin to adiponectin ratio in pericoronary fat may improve prognosis in prediabetic patients with AMI. Trial registration Clinical Trial NCT03360981, Retrospectively Registered 7 January 2018.
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    • Contributed Indexing:
      Keywords: Acute myocardial infarction; Adipokines; Inflammation; Metformin; Pericoronary fat; Prediabetes
    • Molecular Sequence:
      ClinicalTrials.gov NCT03360981
    • Accession Number:
      0 (ADIPOQ protein, human)
      0 (Adiponectin)
      0 (Biomarkers)
      0 (Hypoglycemic Agents)
      0 (Inflammation Mediators)
      0 (LEP protein, human)
      0 (Leptin)
      0 (TNF protein, human)
      0 (Tumor Necrosis Factor-alpha)
      9100L32L2N (Metformin)
      EC 3.5.1.- (SIRT6 protein, human)
      EC 3.5.1.- (Sirtuins)
    • Publication Date:
      Date Created: 20191002 Date Completed: 20200511 Latest Revision: 20240720
    • Publication Date:
      20240720
    • Accession Number:
      PMC6767640
    • Accession Number:
      10.1186/s12933-019-0931-0
    • Accession Number:
      31570103