Plasma leptin and prognosis in patients with established coronary atherosclerosis

Robert Wolk, Peter Berger, Ryan J. Lennon, Emmanouil S. Brilakis, Bruce D. Johnson, Virend K. Somers

Research output: Contribution to journalArticle

190 Citations (Scopus)

Abstract

This study was designed to evaluate the relationship between plasma leptin and prognosis in patients with angiographically confirmed coronary atherosclerosis. Experimental studies suggest that leptin, an adipose tissue-derived hormone, exerts important cardiovascular effects. Study subjects were recruited prospectively from a cohort of patients undergoing clinically indicated coronary angiography (n = 382). The median duration of follow-up was four years. Follow-up information was available for 361 patients. The combined end point of cardiac death, myocardial infarction (MI), cerebrovascular accident, or re-vascularization occurred in 44 subjects. In the simple Cox model, leptin had a significant (p < 0.001) non-linear/cubic univariate relationship with the combined end point. Other variables associated with prognosis in the univariate analysis were body mass index (BMI), prior MI, insulin resistance, C-reactive protein (CRP), fibrinogen, and number of coronary vessels with >50% stenosis. A positive relationship between leptin and prognosis was also seen when leptin levels were split by quintiles, with a hazard ratio of 6.46 for the highest quintile. The only two variables significantly associated with the combined end point in the multivariate Cox model were leptin (p = 0.004) and number of coronary vessels with >50% stenosis (p < 0.001). A similar relationship between leptin and prognosis was observed when leptin was adjusted for BMI. In patients with angiographically confirmed coronary atherosclerosis, leptin is a novel predictor of future cardiovascular events independent of other risk factors, including lipid status and CRP.

Original languageEnglish (US)
Pages (from-to)1819-1824
Number of pages6
JournalJournal of the American College of Cardiology
Volume44
Issue number9
DOIs
StatePublished - Nov 2 2004

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Leptin
Coronary Artery Disease
Proportional Hazards Models
Pathologic Constriction
Coronary Angiography
Adipose Tissue
Coronary Vessels
Stroke
Myocardial Infarction
Hormones
Lipids

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Plasma leptin and prognosis in patients with established coronary atherosclerosis. / Wolk, Robert; Berger, Peter; Lennon, Ryan J.; Brilakis, Emmanouil S.; Johnson, Bruce D.; Somers, Virend K.

In: Journal of the American College of Cardiology, Vol. 44, No. 9, 02.11.2004, p. 1819-1824.

Research output: Contribution to journalArticle

Wolk, Robert ; Berger, Peter ; Lennon, Ryan J. ; Brilakis, Emmanouil S. ; Johnson, Bruce D. ; Somers, Virend K. / Plasma leptin and prognosis in patients with established coronary atherosclerosis. In: Journal of the American College of Cardiology. 2004 ; Vol. 44, No. 9. pp. 1819-1824.
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