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Leptin Level Predicts Outcome in Coronary Atherosclerosis: Presented at ACC

By Jill Stein

NEW ORLEANS, LA -- March 8, 2004 -- Leptin is a novel and powerful prognosticator of future cardiovascular events in patients with angiographically confirmed coronary atherosclerosis, researchers report. What's more, plasma leptin can predict cardiovascular events in these patients independent of other risk factors, including lipid status and C-reactive protein.

Dr. Robert Wolk, with the Mayo Clinic in Rochester, Minnesota, presented the findings here March 7^th at the 53^rd Annual Scientific Session of the American College of Cardiology.

Leptin is a novel bioactive hormone derived predominantly from the adipose tissue. Although originally viewed as a mediator involved mainly in energy homeostasis, several cardiovascular actions of leptin (such as sympathetic activation, pressor effects, regulation of vascular function, insulin resistance, oxidative stress, enhancement of platelet aggregation and impaired fibrinolysis) suggest that leptin may also play an important role in the development of cardiovascular disease, Dr. Wolk pointed out. The pathophysiological role and clinical predictive value of leptin in humans have not yet been established.

In the study, subjects were recruited prospectively from a cohort of 382 patients undergoing clinically indicated coronary angiography.

All patients were followed for the occurrence of cardiac death, new myocardial infarction, cerebrovascular accident, and revascularization, and the median duration of follow-up was 4 years. Follow-up information was available in 361 patients.

During the follow-up, the endpoint was seen in 44 subjects (5 cardiac deaths, 12 myocardial infarctions, 12 percutaneous coronary interventions, 9 coronary artery bypass grafting operations, and 6 cerebrovascular accidents).

The only two variables significantly associated with the endpoint in the multivariate analysis were leptin (P = .004) and the number of coronary vessels with >50% stenosis (P < .001). A similar relationship between leptin and prognosis was observed when leptin was adjusted for body mass index.

Dr. Wolk said that the findings may have important implications for both clinical risk stratification and for understanding the pathophysiological mechanisms underlying cardiovascular morbidity and mortality.


[Study title: Plasma Leptin Level is an Important and Independent Predictor of Prognosis in Patients With Established Coronary Atherosclerosis. Abstract 408-5]

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