TY - JOUR
T1 - Plasma leptin and prognosis in patients with established coronary atherosclerosis
AU - Wolk, Robert
AU - Berger, Peter
AU - Lennon, Ryan J.
AU - Brilakis, Emmanouil S.
AU - Johnson, Bruce D.
AU - Somers, Virend K.
PY - 2004/11/2
Y1 - 2004/11/2
N2 - 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.
AB - 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.
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U2 - 10.1016/j.jacc.2004.07.050
DO - 10.1016/j.jacc.2004.07.050
M3 - Article
C2 - 15519013
AN - SCOPUS:7044222808
SN - 0735-1097
VL - 44
SP - 1819
EP - 1824
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 9
ER -