Serum Resistin Levels and Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention

Aim: Resistin is an adipocytokine that may link inflammation and atherosclerosis. We studied the associations of resistin levels with cardiovascular events and restenosis. Methods: We measured pre-procedural serum resistin levels in 140 patients with coronary artery disease undergoing elective percutaneous coronary intervention (PCI), of whom 97 had a stent. Restenosis was defined as > 50% stenosis at follow-up angiography. Patients were followed for 3 years for major adverse cardiovascular events (MACE). Results: At 8 +/- 6 months after PCI, re-angiography was performed in 94 (67%) patients, of whom 42 had restenosis. Between 42 patients with restenosis and 52 without restenosis, resistin (4.5 +/- 2.6 vs. 4.5 +/- 2.5 ng/mL) and C-reactive protein (CRP) (median 0.70 vs. 0.70 mg/L) levels did not differ. During 3-year follow-up, MACE occurred in 24 patients (1 death, 21 unstable angina, 2 stroke). Compared with 116 patients without MACE, 24 with MACE had higher resistin (5.4 +/- 2.4 vs. 4.3 +/- 2.5 ng/mL) and CRP (1.30 vs. 0.60 mg/L) levels (p < 0.05). Patients with MACE more often had resistin > 4.0 ng/mL than without MACE (75% vs. 35%, p < 0.001). Resistin correlated with CRP levels (r = 0.31). To clarify the association between MACE and resistin, patients were divided into 2 groups by resistin levels. Kaplan-Meier analysis showed a lower event-free survival rate in patients with resistin > 4.0 ng/mL than without it (p < 0.001). On multivariate analysis, resistin, but not CRP, was an independent predictor of MACE. The hazard ratio for MACE was 3.6 (95% CI = 1.4-9.2) for resistin > 4.0 ng/mL. Conclusion: Serum resistin levels were found to be associated with further cardiovascular events in patients undergoing PCI.