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CLINICAL RESEARCH

Plasma Adiponectin Levels Are Associated With Coronary Lesion Complexity in Men With Coronary Artery Disease

Fumiyuki Otsuka, MD^_*, Seigo Sugiyama, MD, PhD^_*,_*, Sunao Kojima, MD, PhD^_*, Hidetomo Maruyoshi, MD^_*, Tohru Funahashi, MD, PhD, Kunihiko Matsui, MD, MPH, Tomohiro Sakamoto, MD, PhD^_*, Michihiro Yoshimura, MD, PhD^_*, Kazuo Kimura, MD, PhD, Satoshi Umemura, MD, PhD and Hisao Ogawa, MD, PhD^_*

^_* Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Osaka, Japan
Department of General Medicine, Kumamoto University Hospital, Kumamoto, Japan
Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan

Manuscript received November 29, 2005; revised manuscript received May 9, 2006, accepted May 16, 2006.

^_* Reprint requests and correspondence: Dr. Seigo Sugiyama, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto City, Kumamoto 860-8556, Japan (Email: ssugiyam{at}kumamoto-u.ac.jp).

OBJECTIVES: We sought to assess whether plasma adiponectin levels correlate with angiographic coronary lesion complexity in patients with coronary artery disease (CAD).

BACKGROUND: Metabolic disorders, including diabetes mellitus and metabolic syndrome, are important risk factors for acute cardiovascular events, and adiponectin is a key molecule of metabolic disorders, with anti-atherogenic properties. Low plasma adiponectin levels are associated with CAD and future incidence of myocardial infarction. The involvement of adiponectin in coronary plaque vulnerability, which may be reflected by angiographic complex lesions, remains to be elucidated.

METHODS: We measured plasma adiponectin levels in 207 men (152 with stable CAD and 55 with acute coronary syndromes [ACS]). Coronary lesions were classified as of simple or complex appearance.

RESULTS: Plasma adiponectin levels were significantly lower in stable CAD patients with complex coronary lesions (n = 60) than in those with simple lesions (n = 92) (4.14 [range 2.95 to 6.02] vs. 5.27 [range 3.67 to 8.12] µg/ml, p = 0.006). Multiple logistic regression analysis demonstrated that adiponectin level was independently associated with complex lesions (odds ratio 0.514, 95% confidence interval 0.278 to 0.951; p = 0.034). Polytomous logistic regression revealed that adiponectin correlated independently with both single and multiple complex lesions. Among patients with ACS, who had lower adiponectin levels than stable CAD patients, those with multiple complex lesions had significantly lower adiponectin than those with a single complex lesion (3.26 [range 2.26 to 4.46] vs. 4.21 [range 3.36 to 5.41] µg/ml, p = 0.032).

CONCLUSIONS: Plasma adiponectin levels are significantly associated with coronary lesion complexity in men with CAD. Low adiponectin levels may contribute to coronary plaque vulnerability.

Abbreviations and Acronyms   ACS = acute coronary syndrome   CAD = coronary artery disease   CI = confidence interval   hs-CRP = high-sensitivity C-reactive protein   MI = myocardial infarction   OR = odds ratio

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