Atherogenic dyslipidaemia but not total- and high-molecular weight adiponectin are associated with the prognostic outcome in patients with coronary heart disease.

AIMS Adiponectin is closely related to atherogenic dyslipidaemia and may be a clinical important mediator of recurrent coronary heart disease (CHD). However, studies with emphasis on secondary disease prevention are rare. We report data from a prospective study investigating the prognostic value of adiponectin, its high-molecular weight (HMW) form, and of markers of lipid metabolism in patients after their first acute CHD event. METHODS AND RESULTS We measured baseline total- and HMW-adiponectin in 1051 patients aged 30-70 years with incident CHD and a prospective follow-up was conducted [median: 56.6 months (interquartile range: 53.2; 57.5)]. During this period, 95 patients (incidence: 22.3/1000 patient years) experienced a secondary cardiovascular disease (CVD) event. After adjustment by Cox proportional hazard models, neither total- nor HMW-adiponectin was associated with secondary CVD events. In contrast, LDL-cholesterol and markers of atherogenic dyslipidaemia were independently associated with secondary CVD events (relative risk per unit increase: LDL-cholesterol: 1.54; 95%CI 1.18-2.01; P = 0.001, triglycerides: 1.58; 95%CI 1.31-1.90; P < 0.0001 and HDL-cholesterol: 0.34; 95%CI 0.14-0.79; P = 0.01). CONCLUSION Measurement of total- and HMW-adiponectin may add no significant value to risk stratifications in patients with incident CHD. In contrast, approaching atherogenic dyslipidaemia may represent a promising target in secondary prevention programs for high-risk patients.