Low adiponectin levels predict late in-stent restenosis after bare metal stenting in native coronary arteries.
BACKGROUND
Adiponectin, the most abundant protein secreted from adipose tissue, possesses anti-atherogenic properties. This study tested whether adiponectin plasma levels predict in-stent restenosis (ISR) after successful percutaneous coronary intervention (PCI) with bare-metal stents.


METHODS
The study included 148 consecutive patients who had elective PCI with bare-metal stents in de novo lesions of native coronary arteries for symptomatic coronary artery disease. Adiponectin levels were measured by ELISA 3 days or less before PCI.


RESULTS
Angiographic ISR (defined as >50% diameter stenosis) was found in 49 (33%) patients during 6 months of the follow-up. Adiponectin levels were lower in patients with ISR than those without ISR (3.5+/-0.3 vs. 6.9+/-0.4 microg/ml, respectively, p<0.01). Adiponectin levels were inversely correlated with late luminal loss of the stented lesions (r=-0.40, p<0.01). Using multivariate logistic regression analysis, low adiponectin levels (<4.5 microg/ml, arbitrarily determined from a receiver operating characteristic curve) served as a predictor of ISR that was independent of angiographic and procedural variables, and clinical factors known to be associated with ISR (odds ratio, 7.9; 95% CI, 3.0-21; p<0.01). Furthermore, low adiponectin levels also independently predicted target lesion revascularization (n=35) during follow-up (odds ratio, 3.7; 95% CI, 1.4-9.7; p<0.01).


CONCLUSIONS
Low adiponectin levels have a predictive value for late ISR after PCI with bare-metal stents in native coronary arteries.
Kitta
Yoshinobu
Y
Department of Internal Medicine II, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan.
Takano
Hajime
H
Nakamura
Takamitsu
T
Kodama
Yasushi
Y
Umetani
Ken
K
Fujioka
Daisuke
D
Saito
Yukio
Y
Kawabata
Ken-Ichi
K
Obata
Jyun-Ei
JE
Mende
Akira
A
Kobayashi
Tsuyoshi
T
Kugiyama
Kiyotaka
K
D052242:Adiponectin / Q000096:biosynthesis / Q000097:blood*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D023903:Coronary Restenosis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology*; D003331:Coronary Vessels / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects; D013997:Time Factors
D052242:Adiponectin; D015415:Biomarkers