Jitta Sahas Reddy, Vatsavayi Priyanka, Tera Chenna Reddy, Krishnamurthy Shobana, Adla Jala Saisree Reddy, Pasnoor Diksha Sanjana, Dasari Utheja, Farooq Aisha, Maramreddy Supriya, Jammula Kavya, Kesani Medha Reddy, Tripuraneni Sridevi, Jena Nihar, Desai Rupak
Department of Internal Medicine, Mercy Hospital, St Louis, MO 63141, United States.
Department of Internal Medicine, East Tennessee State University, Johnson City, TN 37614, United States.
World J Cardiol. 2025 Jun 26;17(6):105452. doi: 10.4330/wjc.v17.i6.105452.
The persistent burden of cardiovascular (CV) disease in the United States requires innovative and cost-effective prognostic markers that can be relied upon.
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.
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 statistics. To ensure robustness, we performed a sensitivity analysis using the leave-one-out approach.
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 ( = 65.51%, = 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 ( = 0%, = 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.
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.
在美国，心血管疾病持续带来沉重负担，这需要可靠的创新且具成本效益的预后标志物。
深入了解脂联素如何预测冠心病（CAD）患者的全因死亡率和主要不良心血管事件（MACE），并确定脂联素在预测稳定型CAD患者全因死亡率和MACE方面的预后价值。
我们在PubMed、Scopus和谷歌学术上进行了系统检索，以查找截至2023年6月发表的评估脂联素在稳定型CAD患者中长期预后作用的相关研究。使用具有95%置信区间的随机效应模型，我们估计比值比（OR），同时通过统计学评估异质性。为确保稳健性，我们采用逐一剔除法进行敏感性分析。
筛选后，我们纳入了五项前瞻性研究，涉及3225名患者，中位随访时间为3.8年。在研究人群中，常见危险因素包括高血压、糖尿病、高脂血症和吸烟。常用药物为血管紧张素转换酶抑制剂、β受体阻滞剂和他汀类药物。发现全因死亡率的合并调整OR为2.51（95%置信区间：1.36 - 4.62），显示存在异质性（I² = 65.51%，P = 0.03）。另一方面，MACE的合并调整OR为1.04（95%置信区间：1.02 - 1.06），未观察到显著异质性（I² = 0%，P = 0.68）。通过敏感性分析发现，没有一项研究对荟萃分析的总体结果产生显著影响，从而表明其稳健性。
发现脂联素水平较高与CAD患者长期死亡风险和MACE增加相关，这凸显了其作为风险评估和指导治疗策略的具成本效益标志物的潜力。对脂联素作用的进一步研究可能会极大地影响心血管护理中的决策制定和资源分配。
