Plasma adiponectin levels in relation to prognosis in patients with angiographic coronary artery disease.
OBJECTIVE
The objective was to study the associations between adiponectin levels and cardiovascular adverse clinical outcomes in patients with angiographic coronary artery disease (CAD) within the Han Chinese population in Beijing.


METHODS
A total of 449 hospitalized patients with angiographic CAD who were Han Chinese in Beijing participated in the study. Plasma adiponectin levels were examined from blood samples using a type of unique enzyme-linked immunosorbent assay that was developed by our laboratory. All of the patients' clinical data, including previously identified cardiovascular risk factors, creatinine clearance and left ventricle ejection fraction, were recorded after admission, and patients were followed up for 19±8 months. The primary end-point was marked by the occurrence of major adverse cardiovascular events (MACE), which included death, targeted vascular revascularization, acute coronary syndrome, heart failure, and transient ischemic attack (TIA) / stroke.


RESULTS
A total of 109 cases of MACE occurred: 15 cases of death, 66 cases of acute coronary syndrome, 4 cases of TIA/stroke, 6 cases of targeted vessel revascularization, and 18 cases of heart failure. Among all the patients, 173 were assigned to the high adiponectin group and 276 were assigned to the low adiponectin group according to their baseline plasma adiponectin levels. The incidence of MACE was significantly higher in the low adiponectin group (P=.037). In a multivariate Cox regression analysis for adiponectin levels, previously documented risk factors, coronary artery stenosis scores, and low adiponectin levels were indicated as independent predictors of MACE in patients with CAD (RR 1.75; 95% CI, 1.066-2.865; P=.027). Further adjustment for hsCRP, Ccr, LVEF, fasting glucose and lipid profile did not attenuate this association (RR=2.36; 95% CI 1.338-4.167; P=.003). The relative risk for low adiponectin levels after additional adjustment for the coronary score was 2.42 (95% CI 1.367-4.279; P=.002). The Kaplan-Meier survival analysis curve suggested that patients with lower adiponectin concentrations had a decreased event-free survival ratio (log-rank χ(2) =4.592, P=.032).


CONCLUSIONS
The results indicate a potential association between plasma adiponectin levels and cardiovascular prognosis in patients with CAD.
Division of Cardiology, Department of Medicine, Peking Union Medical College Hospital, PUMC, Chinese Academy of Medical Sciences, Beijing 100730, China.
Quan
Q
Li
Yihua
Y
Lu
Lixian
L
Sun
Jianhua
J
Yan
Xiaowei
X
Yan
Ligang
L
Fang
Ming
M
Li
Zhongjie
Z
Fan
D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis; D052242:Adiponectin / Q000097:blood*; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality*; D003643:Death; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D002546:Ischemic Attack, Transient / Q000097:blood / Q000175:diagnosis; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume
D052242:Adiponectin; D015415:Biomarkers