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

Table 1 Baseline clinical characteristics of patients with chronic total occlusion, n (%)/mean ± SD/median (interquartile range)

Variable	Total population (n = 54)1	Poor collateral (Rentrop 0-1) (n = 25)	Good collateral (Rentrop 2-3) (n = 29)	P value
Age (years)	56.1 ± 8.7	57.4 ± 8.9	55.0 ± 8.5	0.312
Male sex	45 (83.3)	20 (80.0)	25 (86.2)	0.548
Body mass index (kg/m2)	25.7 ± 3.2	26.1 ± 3.4	25.3 ± 3.0	0.401
Hypertension	23 (42.6)	12 (48.0)	11 (37.9)	0.462
Diabetes mellitus	20 (37.0)	12 (48.0)	8 (27.6)	0.118
Dyslipidemia	29 (53.7)	13 (52.0)	16 (55.2)	0.812
Current smoker	31 (57.4)	16 (64.0)	15 (51.7)	0.361
Left ventricular ejection fraction (%)	51.8 ± 8.1	49.6 ± 8.5	53.7 ± 7.4	0.071
Hemoglobin (g/dL)	13.7 ± 1.4	13.5 ± 1.3	13.9 ± 1.5	0.298
Fasting blood glucose (mg/dL)	118 (96-156)	132 (102-178)	109 (91-140)	0.084
Total cholesterol (mg/dL)	198.4 ± 41.7	203.8 ± 44.2	193.7 ± 39.5	0.386
LDL cholesterol (mg/dL)	126.3 ± 35.6	131.8 ± 37.2	121.6 ± 33.9	0.297
HDL cholesterol (mg/dL)	39.8 ± 8.4	37.6 ± 7.9	41.7 ± 8.5	0.073
Triglycerides (mg/dL)	156 (121-203)	168 (132-228)	149 (116-187)	0.214
Serum creatinine (mg/dL)	1.01 (0.82-1.19)	1.05 (0.86-1.24)	0.98 (0.80-1.16)	0.442
CTO target vessel				0.218
LAD	24 (44.4)	9 (36.0)	15 (51.7)
RCA	21 (38.9)	12 (48.0)	9 (31.0)
LCx	9 (16.7)	4 (16.0)	5 (17.3)

¹Combined cohort of integrated adiponectin and basic fibroblast growth factor datasets.

Statistical comparisons were performed using independent t-tests, Mann-Whitney U tests, χ² tests, or Fisher’s exact tests, as appropriate. LDL: Low-density lipoprotein; HDL: High-density lipoprotein; CTO: Chronic total occlusion; LAD: Left anterior descending artery; RCA: Right coronary artery; LCx: Left circumflex artery.

Table 2 Correlation between biomarkers and coronary collateral grade

Variable	Spearman ρ	95% confidence interval	P value
Coronary collateral grade (Rentrop score)
Serum adiponectin (μg/mL)	0.462	0.217-0.660	< 0.001
Serum bFGF (pg/mL)	0.086	-0.160 to 0.321	0.312
Other clinical variables
Age (years)	-0.128	-0.366 to 0.127	0.377
Diabetes mellitus (yes/no)	-0.214	-0.439 to 0.032	0.087
Hypertension (yes/no)	-0.097	-0.331 to 0.153	0.458
Current smoking (yes/no)	-0.191	-0.420 to 0.063	0.136

Data are presented as Spearman correlation coefficients (ρ). bFGF: Basic fibroblast growth factor.

Table 3 Multivariate logistic regression for predictors of good coronary collateral development

Variable	Adjusted OR	95%CI	P value
Serum adiponectin (per 1 μg/mL increase)	1.86	1.25-2.77	0.002a
Serum basic fibroblast growth factor (per 1 pg/mL increase)	0.91	0.48-1.73	0.776
Age (per 1-year increase)	0.98	0.91-1.05	0.531
Diabetes mellitus (yes vs no)	0.46	0.16-1.35	0.156
Hypertension (yes vs no)	0.82	0.28-2.42	0.720
Current smoking (yes vs no)	0.69	0.23-2.08	0.513
CTO target vessel (LAD vs RCA/LCx)	1.74	0.63-4.84	0.286

^aP < 0.05.

Table 3 summarizes the multivariate logistic regression analysis for predictors of good coronary collateral development. After adjustment for the conventional cardiovascular risk factors, serum adiponectin was the only independent predictor of good collateralization (adjusted odds ratio = 1.86, 95% confidence interval: 1.25-2.77; P = 0.002). However, serum basic fibroblast growth factor, age, diabetes mellitus, hypertension, smoking status, and chronic total occlusion target vessel were not independently associated with the development of coronary collateral. These results suggested that adiponectin was a better systemic marker of coronary collateral maturation than circulating basic fibroblast growth factor or conventional clinical risk factors. Outcome: Good coronary collateral development (Rentrop grades 2-3). OR: Odds ratio; CI: Confidence interval; CTO: Chronic total occlusion; LAD: Left anterior descending artery; RCA: Right coronary artery; LCx: Left circumflex artery.