title: Plasma leptin and prognosis in patients with established coronary atherosclerosis.
abstract: OBJECTIVE
  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.
authors.affiliation: Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Wolk
authors.forename: Peter
authors.initials: P
authors.lastname: Berger
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Lennon
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Johnson
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003324:Coronary Artery Disease / Q000097:blood*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D013223:Statistics as Topic
chemical_list: D015415:Biomarkers; D020738:Leptin; D005340:Fibrinogen; D002097:C-Reactive Protein