This prospective study by Maiolino et al. investigated the predictive value of plasma adiponectin levels as a risk marker for future cardiovascular events and mortality in high-risk coronary artery disease (CAD) patients. The authors selected 712 high-risk patients from the Genetic and ENvironmental factors in Coronary Atherosclerosis (GENICA) cohort, who were followed for a median period of 3.8 years. Patients were classified into two subgroups (a high- or a low-plasma adiponectin subgroup) according to median plasma adiponectin (6.38 ug/ml) distribution. Results of this study indicated that plasma adiponectin levels above the median were a marker of a worse cardiovascular prognosis in high-risk CAD patients. For instance, Kaplan-Meier analysis showed a lower rate of cardiovascular deaths in low-plasma adiponectin than high-plasma adiponectin patients. However, when relevant covariates [age, CAD score, left ventricular ejection fraction (LVEF), and calcium channel blockers (CCB) treatment] were considered, the authors could not confirm that plasma adiponectin levels were independently related to cardiovascular outcomes. Accordingly, the authors concluded that overall risk profile, LVEF, medical history, and concurrent medical treatment should be considered when assessing the usefulness of potential biomarkers of cardiovascular disease, such as adiponectin levels, in high-risk patients.
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