Long-term prognostic role of adiponectin in stable coronary artery disease: A meta-analysis of prospective studies.

Abstract

Background: The persistent burden of cardiovascular (CV) disease in the United States requires innovative and cost-effective prognostic markers that can be relied upon.

Aim: To provide insights into how adiponectin can predict all-cause mortality and major adverse CV events (MACE) in patients with coronary artery disease (CAD) and to determine the prognostic value of adiponectin in predicting all-cause mortality and MACE in patients with stable CAD.

Methods: We conducted a systematic search on PubMed, Scopus, and Google Scholar to find relevant studies published through June 2023 evaluating the long-term prognostic role of adiponectin in patients with stable CAD. Using a random effects model with 95%CI, we estimated the odds ratio (OR) while assessing heterogeneity through I² statistics. To ensure robustness, we performed a sensitivity analysis using the leave-one-out approach.

Results: After screening, we included five prospective studies involving 3225 patients who were followed up for a median duration of 3.8 years. Within the study population, prevalent risk factors included hypertension, diabetes, hyperlipidemia, and smoking. The commonly prescribed medications were angiotensin-converting enzyme inhibitors, beta blockers, and statins. The combined adjusted OR for all-cause mortality was found to be 2.51 (95%CI: 1.36-4.62), showing heterogeneity (I² = 65.51%, P = 0.03). On the other hand, the combined adjusted OR for MACE was determined to be 1.04 (95%CI: 1.02-1.06) with no significant heterogeneity observed (I² = 0%, P = 0.68). Through a sensitivity analysis, it was discovered that none of the studies significantly impacted the overall results of the meta-analysis, thus indicating their robustness.

Conclusion: Higher levels of adiponectin were found to be associated with an increased risk of long-term mortality and MACE in patients with CAD, which highlights its potential as a cost-effective marker for risk assessment and guiding treatment strategies. Further research on the role of adiponectin could greatly influence decision-making and resource allocation in CV care.