This prospective study by Schnabel et al. strengthened the association of adiponectin with adverse cardiovascular outcome during the 2.5 year follow-up in 1,980 patients with documented coronary artery disease (CAD) (1,130 with stable angina (SAP) and 760 with acute coronary syndrome (ACS)). The study showed that adiponectin was an indicator of adverse cardiovascular outcomes in addition to classical risk factors. Kaplan-Meier survival analysis showed a stepwise decrease in event-free survival across quartiles of baseline adiponectin concentrations. Moreover, univariate analysis revealed that adiponectin, as a continuous variable, was related to event-free survival in all patients [HR: 1.02, (95% CI, 1.0-1.04; p=0.012)] as well as in the SAP subgroup [HR: 1.03, (95% CI, 1.01-1.05; p=0.012)]. However, this relationship was non-significant in the ACS subgroup [HR: 1.014, (95% CI, 0.99-1.04; p=0.28)]. These associations remained nearly unchanged in all patients after adjusting for classical risk factors and cardiac medication. Furthermore, a one quartile increase in adiponectin concentration was associated with a 1.17 fold (95% CI, 1.04-1.31; p=0.013) increased risk for future cardiovascular events in the overall population. Finally, in contrast to previous studies including initially healthy individuals, this prospective study demonstrated that adiponectin concentrations could be associated with adverse cardiovascular outcomes in patients with documented CAD.
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