Adiponectin and basic fibroblast growth factor predict coronary collateral development in chronic total occlusion

doi:10.4330/wjc.124634

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World Journal of Cardiology

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1949-8462

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Cardiol. Sep 26, 2026; 18(9): 124634
Published online Sep 26, 2026. doi: 10.4330/wjc.124634

Adiponectin and basic fibroblast growth factor predict coronary collateral development in chronic total occlusion

Azhari Gani, Muhammad Diah, Muhammad Riswan, Muwardi, Heriadi

Azhari Gani, Muhammad Diah, Muwardi, Heriadi, Department of Internal Medicine, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Aceh, Indonesia

Muhammad Riswan, Hematology and Oncology Division, Department of Internal Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Aceh, Indonesia

Author contributions: Gani A and Diah M developed the methodology and supervised the study; Gani A, Diah M and Riswan M revised the manuscript; Gani A conceived the study and interpreted the data; Diah M performed the statistical analysis; Muwardi and Heriadi performed the study; Heriadi conducted the laboratory analyses, curated the data, and prepared the original draft; Muwardi recruited the patients and collected the clinical data; Riswan M validated the results, interpreted the clinical data, and prepared the figures. The authors have read and approved the final version of the manuscript.

AI contribution statement: The only AI tool used was ChatGPT (OpenAI) to help with English-language editing, sentence refinement, and improving manuscript readability. The study hypothesis was not generated by an AI tool. The methodology was not designed by an AI tool. The data analysis was not carried out by an AI tool. The study results were not interpreted by an AI tool. The scientific conclusions were not formulated by an AI tool. The authors are solely responsible for the intellectual content, critical interpretation, and final approval of the manuscript, as well as for its accuracy and integrity.

Institutional review board statement: The study protocol was approved by the Health Research Ethics Committee of RSUD Dr. Zainoel Abidin, Banda Aceh, Indonesia (approval No. 034/ETIK-RSUDZA/2025). All procedures performed in studies including human participants were in accordance with the ethical standards of the Declaration of Helsinki and the CIOMS guidelines 2016.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: Data supporting the results of this study are available from the corresponding author upon reasonable request. Data containing personally identifiable information are not publicly available due to institutional privacy and ethics regulations.

Corresponding author: Azhari Gani, Associate Professor, Lecturer, Department of Internal Medicine, Faculty of Medicine, Universitas Syiah Kuala, Darussalam, Banda Aceh 23111, Aceh, Indonesia. azharigani@usk.ac.id

Received: June 29, 2026
Revised: August 4, 2026
Accepted: September 22, 2026
Published online: September 26, 2026
Processing time: 94 Days and 20.5 Hours

Abstract

BACKGROUND

Coronary collateral circulation is an adaptive mechanism to protect myocardial perfusion in patients with chronic total occlusion. However, the relative importance of metabolic and angiogenic biomarkers in collateral development remained unclear.

AIM

To examine the associations of serum adiponectin and basic fibroblast growth factor (bFGF) with coronary collateral development.

METHODS

A cross-sectional study was carried out on 54 patients with angiographically proven chronic total occlusion. Coronary collateralization was classified by Rentrop grading system as poor and good with grades of 0-1 and 2-3, respectively. Serum adiponectin and bFGF levels were measured using enzyme-linked immunosorbent assay. Spearman correlation, multivariate logistic regression, and receiver operating characteristic analyses were conducted to assess associations, identify independent predictors, and evaluate diagnostic performance.

RESULTS

Serum adiponectin levels were significantly higher in patients with good collateralization compared to those in the poor category (P < 0.001). Adiponectin was positively correlated with Rentrop grade and remained an independent predictor of good collateral development after multivariable adjustment. Serum bFGF levels were not significantly different between groups and were not independently associated with collateral maturation. Furthermore, adiponectin-bFGF model produced better prediction performance than either biomarker alone.

CONCLUSION

Serum adiponectin was an independent predictor of coronary collateral development. Meanwhile, circulating bFGF had limited utility as a systemic biomarker of collateral maturation.

Keywords: Adiponectin; Angiogenesis; Basic fibroblast growth factor; Chronic total occlusion; Coronary collateral circulation

Core Tip: Coronary collateral development is an important adaptive response in chronic total occlusion. This study shows that serum adiponectin is independently associated with well-developed coronary collateral circulation, while circulating basic fibroblast growth factor has limited predictive value. The results show that adiponectin serves as a useful clinical biomarker and risk stratification for collateral assessment and ischemia, respectively. It also shows the complementary roles of metabolic and angiogenic pathways in adaptive coronary vascular remodeling.