Background: Adiponectin is thought to protect against atherosclerosis and its expression is decreased in metabolic syndrome and diabetes mellitus. Adiponectin has a high-molecular-weight (HMW) multimer structure in the blood. We determined whether circulating HMW adiponectin, total adiponectin, or their ratio predicts baseline angiographic coronary artery disease (CAD) severity and restenosis after percutaneous coronary intervention (PCI).
Methods: Patients with stable angina pectoris who underwent PCI for a de novo lesion and had angiographic follow-up at our hospital were retrospectively enrolled. The study patients were grouped as moderate (N=68) or severe (N=63) coronary atherosclerosis by the baseline median Gensini severity score (moderate<22, severe> or =22).
Results: Univariate analysis showed that subjects in the severe CAD group had a lower HMW/total adiponectin ratio (0.32+/-0.19 vs. 0.37+/-0.16, p=0.024) while the absolute value of HMW adiponectin (2.17+/-2.05 vs. 2.27+/-2.07 microg/ml, p=0.389) and total adiponectin (5.97+/-3.12 vs. 5.76+/-2.91 microg/ml, p=0.807) were similar between the severe and moderate CAD groups. In a multivariate binary logistic regression model, a higher serum HMW/total adiponectin ratio (odds ratio 0.058, p=0.018) was negatively, while hypercholesterolemia (OR 2.475, p=0.029) was positively associated with coronary atherosclerosis disease severity. In terms of restenosis after PCI (mean follow-up at 12+/-13 months), HMW adiponectin, total adiponectin and their ratio were similar between restenotic (N=91) and non-restenotic groups (N=40).
Conclusions: A decreased ratio of circulating HMW adiponectin to total adiponectin is associated with angiographic disease severity but not restenosis in CAD patients undergoing PCI.