Increased serum levels of the novel adipokine C1q and tumor necrosis factor related protein 1 (C1QTNF1) have been linked with type 2 diabetes (T2DM) and ischemic heart disease. The impact of circulating C1QTNF1 on the incidence of future major cardiovascular events (MACE) is unclear and is addressed in the present study. We measured C1QTNF1 serum levels in 542 patients undergoing coronary angiography for the evaluation of established or suspected coronary artery disease (CAD) using an enzyme-linked immunosorbent assay. Prospectively, MACE were recorded over a mean follow-up period of 6.3 years. C1QTNF1 serum levels at baseline were significantly increased in patients with T2DM (n=160) compared to those without diabetes (521.4 ± 224.8 vs. 429.5 ± 130.3 ng/ml; p<0.001). Prospectively, the incidence of MACE increased significantly through tertiles of C1QTNF1 (17.8%, 24.7%, and 29.7% in the 1st, 2nd and 3rd tertiles, respectively; ptrend=0.010). Also after adjustment for age, sex, and T2DM as well as after additional adjustment for body mass index, hypertension, LDL cholesterol, HDL cholesterol, triglycerides, and angiographically determined baseline CAD, C1QTNF1 significantly predicted MACE, with adjusted HRs of 1.30 [1.04-1.61]; p=0.019 and 1.36 [1.09-1.70]; p=0.007, respectively. Patients with T2DM were at a significantly higher risk of MACE than those who did not have diabetes (48% vs. 26%; p=0.003). C1QTNF1 in subgroup analyses also in T2DM patients proved to be a strong predictor of MACE (adjusted HR 1.57 [1.10-2.24]; p=0.013). We conclude that high serum levels of C1QTNF1 significantly predict MACE, in particular in patients with T2DM.


A. Muendlein: None. A. Leiherer: None. C.H. Saely: None. K. Geiger: None. J. Ebner: None. E. Brandtner: None. B. Larcher: None. A. Mader: None. P. Fraunberger: None. H. Drexel: None.

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