Abstract 4350: Both Plasma and Tissue Expression of Adiponectin Were Prognostic Factors After Coronary Artery Bypass Grafting in Patients With Coronary Artery Disease
Background: Adiponectin is protective against diabetes and cardiovascular disease in healthy subjects, but correlates with poor prognosis in patients with heart failure and coronary artery disease. The prognostic values of plasma and tissue expression of adiponectin have not been elucidated in subjects after coronary artery bypass grafting (CABG).
Methods: Patients submitted for CABG by a single cardiac surgeon team were prospectively enrolled. Preoperative blood samples and residual left internal mammary artery (LIMA) were harvested. Subjects were followed in outpatient clinics.
Results: Among the 146 consecutive patients (aged 69.7±11 years), 9 patients died in the hospital after CABG. They had more manifest acute coronary syndrome, lower LVEF, higher white blood cell counts, high sensitivity C-reactive protein (hsCRP), adiponectin, Nt-proBNP levels, and intima-media ratio of LIMA before surgery. Both hsCRP and adiponectin levels were the independent predictors of in-hospital mortality in multivariate analysis. In the 137 patients discharged alive, there were 32 mortalities, 4 non-fatal MIs, and 4 non-fatal strokes during a mean follow-up duration of 3.4 years. HsCRP, intima-media ratio, and medial expression of adiponectin predicted all-cause mortality, independent of traditional risk factors. Both plasma and endothelial expression of adiponectin were independent predictors for adverse cardiovascular events.
Conclusions: Increased preoperative hsCRP and adiponectin levels independently predicted in-hospital mortality after CABG. Both plasma and vascular expression of adiponectin were associated with adverse events in patients underwent CABG.