Prognostic value of adiponectin level in patients with coronary artery disease: a systematic review and meta-analysis

BACKGROUND: Conflicting results on the prognostic value of blood adiponectin level in patients with coronary artery disease (CAD) have been reported. This meta-analysis aimed to investigate the prognostic value of elevated adiponectin level in CAD patients. METHODS: A comprehensive literature search was conducted in PubMed and Embase databases up to May 10, 2019. Studies evaluating the association between adiponectin level and major adverse cardiovascular events (death, stroke, acute coronary syndrome or coronary revascularisation), cardiovascular mortality, and all-cause mortality in CAD patients were included. Pooled multivariable adjusted risk ratios (RR) and 95% confidence intervals (CI) was calculated for the highest vs the lowest category of adiponectin level. RESULTS: Twelve studies including 10,974 CAD patients were included. Elevated adiponectin level was independently associated with higher risk of cardiovascular (RR 1.93; 95% CI 1.55-2.42; p < 0.001) and all-cause mortality (RR 1.96; 95% CI 1.64-2.34; p < 0.001) in CAD patients. However, CAD patients with higher adiponectin level did not significantly increase major cardiovascular events risk (RR 1.12; 95% CI 0.86-1.45; p = 0.407) after adjustment for potential confounders. CONCLUSIONS: This meta-analysis indicates that elevated adiponectin level is an independent predictor of cardiovascular and all-cause mortality in CAD patients. Measurement of blood adiponectin level has potential to identify CAD patients who have high risk of death.