Background and Objectives: Pulse wave velocity (PWV) is an index of arterial stiffness. Atherogenic molecules may be involved in the process of arterial stiffening. Adiponectin is an antiatherosclerotic cytokine and matrix metalloproteinase-9 (MMP-9) is a marker of vascular extracellular remodeling. The aim of this study was to investigate the relationship among the levels of adiponectin and MMP-9 in patients with significant atherosclerotic coronary artery diseases (CAD) and to evaluate that PWV could predict the severity of CAD such as the number of diseased vessel and presence of calcification. Methods and Results: Regional PWV were measured by noninvasive applanation tonometry in patients with coronary artery stenosis of more than 70% on coronary angiography (n=403) and in the healthy control group (n=197). Biomarkers including hsCRP, adiponectin, and MMP-9 were analyzed. The levels of carotid-femoral PWV (cfPWV) in CAD group were significantly higher than those of the control group (8.42 짹 1.27 m/s vs. 7.81 짹 0.77 m/s, P < 0.001). The levels of cfPWV were higher in diabetic CAD patients than in non-diabetic patients by 8% (P < 0.001), higher in patients with two or three-vessel disease than in patients with one-vessel disease by 6% (P < 0.001), and higher in patients with presence of calcified coronary vessels than in patients without coronary calcification by 12% (P < 0.001). Serum adiponectin levels were significantly lower in the CAD group (3.73 짹 2.41ug/ml) than in the control group (6.69 짹 3.37 ug/ml, P < 0.001). The levels of serum MMP-9 were significantly higher (0.48 짹 0.38 ug/ml) in the CAD group than in the control group (0.34 짹 0.25 ug/ml, P < 0.001). Conclusions: The aortic PWV was significantly associated with both the presence and severity of coronary artery atherosclerosis. The presence of atherosclerotic CAD could modulate the blood levels of adiponectin and MMP-9.