ARTHEROSCLEROSIS
Plasma leptin and prognosis in patients with established coronary atherosclerosis
Robert Wolk, MD, PhD*, ,
Peter Berger, MD, FACC*,
Ryan J. Lennon, MS ,
Emmanouil S. Brilakis, MD*,
Bruce D. Johnson, PhD* and
Virend K. Somers, MD, PhD, FACC*,,*
* Cardiovascular Diseases
Hypertension
Biostatistics, Mayo Clinic, Rochester, MinnesotaUSA
Manuscript received June 7, 2004;
accepted July 28, 2004.
* Reprint requests and correspondence: Dr. Virend K. Somers, Mayo Clinic, Saint Mary’s Hospital, 1216 Second Street SW, Rochester, Minnesota 55902
(Email: somers.virend{at}mayo.edu).
OBJECTIVES: This study was designed to evaluate the relationship between plasma leptin and prognosis in patients with angiographically confirmed coronary atherosclerosis.
BACKGROUND: Experimental studies suggest that leptin, an adipose tissue-derived hormone, exerts important cardiovascular effects.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
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Abbreviations and Acronyms
| | BMI = body mass index | | CABG = coronary artery bypass grafting | | CRP = C-reactive protein | | CVA = cerebrovascular accident | | HDL = high-density lipoprotein | | LDL = low-density lipoprotein | | MI = myocardial infarction | | PCI = percutaneous coronary intervention |
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16(2):
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158(3):
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|
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|
|
|
|
|
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133(3):
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|
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|
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|
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|
|
|
|
|
|
|
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27(9):
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|
|
|
|
|
|
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|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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115(10):
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|
|
|
|
|
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|
|
|
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|
|
|
|
|
|
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27(19):
2263 - 2265.
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|
|
|
|
|
|
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|
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|
|
|
|
|
|
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|
|
|
|
|
|
|
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|
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