الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 107 |  |  |
| | | from | 107 | | |
Abstract
The potential role of adiponectin in cardiovascular diseases has been observed in patients with coronary artery diseases (CAD), as they have lower levels of adiponectin irrespective of ethnic group(Lu et al., 2007).
Coronary angiography is widely used to define the presence and severity of coronary artery disease; many scoring systems are used for research purposes and clinically. The most frequently used is modified Gensini score.
Modified Gensini score: is a method that assigns a different severity score depending on the degree of luminal narrowing and geographical importance of its lesions (Gensini, 1983).
The study was done to assess the association between serum adiponectin levels and the severity of CAD.
This cross-sectional study included ninety subjects recruited from catheterization unit in Menoufia University Hospital and Sohag Cardiac Center who underwent elective coronary angiography in the period from January 2016 to December 2016 for evaluation of coronary anatomy.
All patients were subjected to history taking, complete physical examination, 12 leads ECG, laboratory investigations including serum creatinine, lipid profile and serum adiponectin levels, trans-thoracic echocardiography and coronary angiography. The severity of CAD was investigated using the modified Gensini score.
The study found that:
There was no statistically significant difference as regard to age and sex in the studied groups.
Smoking was significantly more prevalent in patients with CAD than those with normal coronary arteries group.
There was no statistically significant difference regarding prevalence of hypertension, dyslipidemia and family history in the studied groups.
Serum adiponectin levels in patients with CAD were found to be statistically highly significant lower than those with normal coronary arteries group, and there was no statistically significant difference in patients with single-vessel disease. While, it was found to be significantly lower in the patients with two-vessels, multi-vessels, and LM disease compared to normal coronary artery group.
When analyzing subgroups of patients with CAD, we found that, serum adiponectin levels were statistically significant lower in patients with two-vessels, multi-vessels, and LM disease compared to patients with single-vessel disease. Also, it was statistically significant lower in patients with multi-vessels disease compared to patients with two-vessels disease. While, there was no statistically significant difference in patients with LM disease compared to patients with multi-vessels and two-vessels disease.
As regard to modified Gensini score, it was highly statistically significant higher in patients with two-vessels disease 33.75±17.73, multi-vessels disease 67.28±41.61 and left-main disease 80.16±47.25 compared to patients with single-vessel disease 8.02±6.0, and in patients with multi-vessels and left-main disease compared to patients with two-vessels disease.
There was a significant linear negative correlation between serum adiponectin levels and modified Gensini score in the studied patients group and subgroups.
Receive-operating characteristics (ROC) curve showed that cut-off value of serum adiponectin level for detection of CAD was <4.6μg/ml with sensitivity 85%, specificity 69%, accuracy 79%, PPV 81% and NPV 76%.
As regard to cut-off values of serum adiponectin level for prediction of severity of CAD in two-vessels disease, it was ≤4.4μg/ml, for multi-vessels disease, it was <3.9 μg/ml, and finally for single-vessel disease, it was <3.8 μg/ml.
According to AUC of serum adiponectin level, it was very good test for detection of CAD, and for prediction of severity of CAD, it was excellent test in multi-vessels and left-main disease, very good in two-vessels disease, and fair in single-vessel disease.