Abstract 1546: High-Molecular Adiponectin as a Marker of Coronary Artery Disease
Background: Adiponectin is an adipocyte-specific secretory protein that is highly and specifically expressed in adipose tissue. Plasma adiponectin level is decreased in obese individuals, to be negatively correlated with visceral fat accumulation and the lower level of adiponectin has been suggested to be associated with coronary artery disease, especially with the development of acute coronary syndrome. In human plasma, adiponectin circulates as a trimer, a hexamer and a high-molecular weight multimer. High-molecular weight (HMW) adiponectin of 420kDa is suggested to be more important as to vascular protective activities than total amount of adiponectin. However, clinical significance of the plasma HMW adiponectin in co0ronary artery disease is not evident.
Methods and Results: We measured HMW adiponectin level in 149 patients undergoing diagnostic coronary angiography, suspected of chronic coronary artery disease. The high molecular adiponectin level was lower in patients with vasospastic angina (3.4±2.4μg/dl, P<0.01), stable effort angina (3.3±2.6, P<0.001) and old myocardial infarction (3.8±2.9, P<0.01), compared to chest pain syndrome patients (control) (6.6±5.4). The level was lower in patients with multi-vessel disease (3.4±2.4μg/dl), compared to patients with single vessel disease (4.2±2.7, P<0.05) or no organic stenosis (5.1±4.5, P<0.01). During observation of 7 years’ follow-up, onset of cardiovascular events was seen in 50 patients (34%). Among various risk factors, diabetes (P=0.02), insulin resistance assessed by homeostasis model assessment (P=0.06), no statin use (P=0.08), high sensitive C reactive protein level (P=0.0012) and HMW adiponectin level (P=0.0037) could predict cardiovascular events in univariate logistic regression analysis. However, multiple logistic regression analysis using these parameters showed that only HMW adiponectin was an independent predictor of cardiovascular event (OR; 2.23, 95%CI; 1.06 – 4.69, P=0.035).
Conclusion: HMW adiponectin may be not only a marker for severity of coronary artery disease but also a predictor of future cardiovascular events in patients with coronary artery disease.