Irisin is a newly discovered myokine, associated with 'browning' of the white adipose tissue, obesity, insulin resistance and metabolic syndrome. The purpose of this study is to evaluate circulating irisin as a predictor of acute coronary syndromes (ACSs) and major adverse cardiovascular events (MACE).
Sub-study 1: a case–control study, nested within the Veteran’s Affairs Normative Ageing Study, evaluating circulating irisin levels in 88 ACS cases and 158 age- and sampling year-matched controls, as a predictor of ACS. Sub-study 2: a prospective cohort study, where 103 participants with established coronary artery disease were stratified by circulating irisin levels at the time they received percutaneous coronary interventions (PCIs) and were followed for the development of MACE.
Study 1: there was no association between irisin levels and ACS in otherwise healthy individuals (odds ratio: 1.00 95% confidence interval: (0.99–1.00)). Study 2: the incidence of MACE was significantly lower in the first irisin tertile compared with the second and third (incidence rate 0 vs 0.92 (0.51–1.61) vs 0.57 (0.28–1.14) events per 1000 person-days; P<0.01). This was primarily driven by the lower incidence of unstable angina (incidence rate 0 vs 0.61 (0.31–1.22) vs 0.43 (0.19–0.96) per 1000 person-days; P=0.01).
This is the first study to date that demonstrates that, although circulating irisin levels do not predict the development of ACS in healthy individuals, increased irisin levels are associated with the development of MACE in patients with established coronary artery disease after PCI.
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The Mantzoros Laboratory is supported by Award Number 1I01CX000422–01A1 from the Clinical Science Research and Development Service of the VA Office of Research and Development. NAS is supported by Cooperative Studies Program/ERIC, US Department of Veterans Affairs and is a research component of the Massachusetts Veterans Epidemiology Research and Information Center. Dr Spiro is supported by a Research Career Scientist award from the Clinical Science Research and development service, US department of veterans’ affairs. This study was also supported by the Spanish Ministry of Health (FIS 2011-00214) and CIBERobn Fisiopatología de la Obesidad y la Nutrición (CIBERobn). The CIBER de la Fisiopatología de la Obesidad y Nutrición (CIBERobn) is an initiative from the Instituto de Salud Carlos III (ISCIII).
All authors have read and agree with the content of the manuscript. KNA wrote the manuscript, collected data and performed the statistical analysis. MM contributed in the prospective study of this project, wrote the manuscript and collected data. SAP wrote the manuscript and contributed to the statistical analysis. JMM-N, WR, ED, JdlH contributed in the prospective study of this project. AS-E, ASIII, PV coordinated the Normative Ageing Study. JPC and RB performed the assays. JM-F-R and CSM supervised the study
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Supplementary Information accompanies this paper on International Journal of Obesity website (http://www.nature.com/ijo)