Circulating adiponectin level is associated with major adverse cardiovascular events in type 2 diabetic patients with coronary artery disease

Elevated levels of circulating adiponectin (ADPN), an anti- inflammatory and anti-oxidative peptide, are associated with unfavorable cardiovascular outcomes in patients with cardiovascular diseases. The aim of this study was to investigate whether plasma ADPN levels could help predict major adverse cardiovascular events (MACE) in patients with documented coronary artery disease (CAD). We prospectively enrolled 193 CAD patients, who underwent percutaneous coronary intervention (PCI), and/or stenting and coronary artery bypass graft (CABG) surgery. ELISA was used to measure plasma ADPN concentrations. MACE--myocardial infarction, PCI, CABG, stroke, carotid revascularization, and death--was evaluated during a follow-up period of median 15.3 months (range 5-21 months). Cox regression analysis revealed that diabetes status, waist circumference, and plasma ADPN levels were significantly associated with MACE occurrence. On stratification according to diabetes status, plasma ADPN levels helped predict MACE only in patients with type 2 diabetes mellitus (T2DM). Kaplan-Meier analysis revealed higher MACE rates in diabetic patients with high-plasma ADPN levels than in those with low-plasma ADPN levels. High ADPN plasma concentrations can independently be associated with MACE in CAD with T2DM but not in those without diabetes. This indicates that plasma ADPN may have potential roles in high risk T2DM patients with ischemic heart disease.