title: Prognostic value of adiponectin in coronary artery disease: Role of diabetes and left ventricular systolic dysfunction.
abstract: OBJECTIVE
  Adiponectin (AD) promotes insulin sensitivity and has anti-atherogenic properties. However, the role of AD on clinical outcomes in coronary artery disease (CAD) is controversial. We analyzed whether AD was an independent predictor of all-cause mortality and hospitalization in patients with CAD.
  
  
  METHODS
  We prospectively enrolled 138 patients with stable CAD, with or without type 2 diabetes and with or without left ventricular dysfunction. A telephone follow-up was conducted to register long term outcomes. Sensitivity/specificity ratio for AD was investigated with ROC analysis and the independent role of AD on outcome was evaluated with Cox regression model of analysis. The survival rate was represented by Kaplan Meyer curves.
  
  
  RESULTS
  Of 138 patients, 61 had type 2 diabetes and 71 left ventricular systolic dysfunction (EF<40%). Median time of follow-up was 1384days; mortality rate was 18.8% (26 deaths) and hospitalization rate was 47.1% (65 events). Mean concentration of AD was 9.87±7.53ng/ml; the analysis of the ROC curve identified an AD cut-off level of 13.2ng/ml (AUC 0.779; p<0.0001). Patients with AD >13.2ng/ml had a significantly higher risk of death (HR=6.50; 95% CI: 2.40-17.70), but not of cardiovascular hospitalization (HR=0.87; 95% CI: 0.31-2.44). AD predictivity remained significant also in patients with type 2 diabetes and with left ventricular systolic dysfunction.
  
  
  CONCLUSIONS
  In stable CAD, an AD value of >13.2ng/ml independently predicts a 6-fold increased risk of all-cause mortality.
authors.affiliation: Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Ageing, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pratesi
authors.affiliation: Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Ageing, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Di Serio
authors.affiliation: Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Ageing, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Orso
authors.affiliation: Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Ageing, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Foschini
authors.affiliation: Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Ageing, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Nadia
authors.initials: N
authors.lastname: Bartoli
authors.affiliation: Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Ageing, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Marella
authors.affiliation: Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Ageing, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Fumagalli
authors.affiliation: Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Ageing, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Di Bari
authors.affiliation: Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Ageing, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Niccolò
authors.initials: N
authors.lastname: Marchionni
authors.affiliation: Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Ageing, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Tarantini
authors.affiliation: Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Ageing, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy; Intensive Care Unit, Division of Cardiology, Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi (AOUC), Florence, Italy. Electronic address: pesine@libero.it.
authors.forename: Samuele
authors.initials: S
authors.lastname: Baldasseroni
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D013599:Systole; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D052242:Adiponectin
keywords: Adiponectin; Coronary artery disease; Heart failure; Type 2 diabetes