European Heart Journal Advance Access originally published online on July 24, 2006
European Heart Journal 2006 27(19):2300-2309; doi:10.1093/eurheartj/ehl153
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Adiponectin is an independent predictor of all-cause mortality, cardiac mortality, and myocardial infarction in patients presenting with chest pain
1 Division of Cardiology, Department of Medicine, SUNY Downstate Medical Center, 450 Clarkson Avenue, Box 1257, Brooklyn, NY 11203-2098, USA
2 Division of Cardiology, Department of Medicine, Bronx Veterans Affairs Medical Center, Bronx, NY, USA
3 Division of Cardiovascular Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, USA
Received 24 February 2006; revised 22 June 2006; accepted 29 June 2006; online publish-ahead-of-print 24 July 2006.
* Corresponding author. E-mail address: jonathan{at}marmur.com
See page 2266 for the editorial comment on this article (doi:10.1093/eurheartj/ehl248)
Aims To determine the prognostic value of baseline plasma adiponectin levels in patients with known or suspected coronary artery disease referred for coronary angiography.
Methods and results Adiponectin was measured in 325 male patients with stable angina, troponin-negative unstable angina, and non-ST-segment elevation myocardial infarction (MI) undergoing coronary angiography at a Veterans Administration Medical Center. The patients were then followed prospectively for the occurrence of all-cause mortality, cardiac mortality, and MI. Follow-up data at 24 months were available for 97% of the patients. Adiponectin was the only biomarker to independently predict the individual endpoints of all-cause mortality, cardiac mortality, and MI. The 24-month survival rates for patients in the lower (
4.431 mg/L), middle (>4.431 and 8.008 mg/L), and upper (>8.008 mg/L) tertiles of plasma adiponectin values were 95.0, 90.4, and 83.5%, respectively (P=0.0232 by log-rank test). Furthermore, when patients with chest pain were risk-stratified into those with and without a non-ST-segment elevation acute coronary syndrome (NSTEACS), adiponectin remained an independent predictor of both all-cause mortality and cardiac mortality in the NSTEACS subgroup.
Conclusion In a cohort of male patients undergoing coronary angiography, a single baseline determination of plasma adiponectin is independently predictive of the subsequent risk of death and MI.
Key Words: Inflammation • Adiponectin • Prognosis • Body mass index • TIMP-1 • Biomarker • IL-10
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