European Heart Journal Advance Access originally published online on April 5, 2008
European Heart Journal 2008 29(10):1307-1315; doi:10.1093/eurheartj/ehn135
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Atherogenic dyslipidaemia but not total- and high-molecular weight adiponectin are associated with the prognostic outcome in patients with coronary heart disease
1 Department of Medicine I and Clinical Chemistry, Ruprecht-Karls-University of Heidelberg, Germany
2 Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
Received 13 September 2007; revised 3 March 2008; accepted 10 March 2008; online publish-ahead-of-print 5 April 2008.
* Corresponding author. Department of Nephrology, Technical University Munich, Ismaningerstr. 22, 81675 Munich, Germany. Tel: +49 89 4140 6701, Fax: +49 4140 4878, Email: maximilian.eynatten{at}lrz.tum.de or meynatten{at}yahoo.de
See page 1221 for the editorial comment on this article (doi:10.1093/eurheartj/ehn185)
Aims: Adiponectin is closely related to atherogenic dyslipidaemia and may be a clinical important mediator of recurrent coronary heart disease (CHD). However, studies with emphasis on secondary disease prevention are rare. We report data from a prospective study investigating the prognostic value of adiponectin, its high-molecular weight (HMW) form, and of markers of lipid metabolism in patients after their first acute CHD event.
Methods and results: We measured baseline total- and HMW-adiponectin in 1051 patients aged 30–70 years with incident CHD and a prospective follow-up was conducted [median: 56.6 months (interquartile range: 53.2; 57.5)]. During this period, 95 patients (incidence: 22.3/1000 patient years) experienced a secondary cardiovascular disease (CVD) event. After adjustment by Cox proportional hazard models, neither total- nor HMW-adiponectin was associated with secondary CVD events. In contrast, LDL-cholesterol and markers of atherogenic dyslipidaemia were independently associated with secondary CVD events (relative risk per unit increase: LDL-cholesterol: 1.54; 95%CI 1.18–2.01; P = 0.001, triglycerides: 1.58; 95%CI 1.31–1.90; P < 0.0001 and HDL-cholesterol: 0.34; 95%CI 0.14–0.79; P = 0.01).
Conclusion: Measurement of total- and HMW-adiponectin may add no significant value to risk stratifications in patients with incident CHD. In contrast, approaching atherogenic dyslipidaemia may represent a promising target in secondary prevention programs for high-risk patients.
Key Words: Coronary heart disease • Epidemiology • Secondary disease prevention • Adiponectin • Dyslipoproteinaemia
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