Elevated serum leptin levels in patients with acute myocardial infarction; correlation with coronary angiographic and echocardiographic findings

Abstract

BackgroundTo assess the relationship between serial serum leptin levels in patients with acute myocardial infarction (AMI) who received thrombolysis and the degree of coronary atherosclerosis, coronary reperfusion, echocardiographic findings, and clinical outcome. 51 consecutive patients presenting with AMI were studied. Clinical characteristics including age, sex, body mass index (BMI) and cardiovascular risk factors were recorded. Serial serum leptin levels at the time of admission and subsequently at 0, 6, 12, 24, 36, 60 hours afterwards were obtained. Coronary angiography was performed in 34 patients; the relation between serum leptin levels and evidence of coronary reperfusion as well as the extent of coronary atherosclerosis according to the coronary artery surgery study classification (CASS) were evaluated. Echocardiographic evaluation was performed in all patients. 36 matched patients were enrolled as control group who had serum leptin level 9.4 ± 6.5 ng/ml.ResultsThe patients mean age was 50.5 ± 10.6 years. There were 47 males and 3 females. 37.1% were diabetics, 23.5% were hypertensive, 21.6% were dyslipidemic and 22.7% were obese (BMI ≥ 30). Leptin concentrations (ng/ml) increased and peaked at the 4th sample (36 hrs) after admission (mean ± SD) sample (1) =9.55 ± 7.4, sample (2) =12.9 ± 8.4, sample (3) =13.8 ± 10.4, sample (4) =18.9 ± 18.1, sample (5) =11.4 ± 6.5, sample (6) =10.8 ± 8.9 ng/ml. There was a significant correlation between serum leptin and BMI (r = 0.342; p = 0.03). Leptin levels correlated significantly to creatine kinase level on the second day (r = 0.43, p ≤ 0.01). Significant correlation of mean serum leptin with the ejection fraction (P < 0.05) was found. No difference in timing of peak serum leptin between patients who achieved coronary reperfusion vs. those who did not (p = 0.8). There was a trend for an increase in the mean serum leptin levels with increasing number of diseased vessels. There was no correlation between serum leptin levels and outcome neither during the hospitalization nor at 9 months follow up.ConclusionSerum leptin levels increase after myocardial infarction. Serum leptin level may be a predictor of the left ventricular ejection fraction and the degree of atherosclerosis but not of coronary reperfusion.

Hubungan Kadar Leptin Serum dengan Kompleksitas Lesi Koroner berdasarkan Skor SYNTAX pada Penderita Penyakit Arteri Koroner Stabil

“…13 yang meneliti hubungan kadar leptin dengan hasil angiografi berdasarkan atas kriteria Coronary Artery Surgery Study (CASS) pada pasien sindrom koroner akut, didapatkan hasil bahwa tidak terdapat hubungan antara kadar leptin dan jumlah arteri koroner yang mengalami aterosklerosis (p=0,6).…”

“…Khafaji dkk. 13 memperlihatkan usia rata-rata subjek penelitian lebih banyak pada kelompok usia <50 tahun (55%), sedangkan komposisi laki-laki sebesar 93%. Sesuai dengan hasil penelitian tersebut bahwa usia rata-rata hampir sama dan prevalensi laki-laki lebih banyak daripada perempuan.…”

“…13 yang meneliti hubungan antara peningkatan kadar leptin dan hasil angiografi pada pasien sindrom koroner akut, didapatkan hasil bahwa terdapat kecenderungan peningkatan kadar leptin serum dengan peningkatan jumlah arteri koroner yang mengalami aterosklerosis, namun hasil ini secara statistik tidak berhubungan. Perbedaan penelitian Khafaji dkk.…”

“…Perbedaan penelitian Khafaji dkk. 13 dengan penelitian ini adalah pada subjek penelitian Khafaji dkk. mempergunakan pasien sindrom koroner akut (SKA) dan juga kriteria penilaian angiografi dengan Coronary Artery Surgery Study (CASS) yang menilai berdasarkan beratnya stenosis, yaitu 50% di left main serta 70% di cabang utama, dan kriteria luas lesi berdasarkan jumlah arteri yang mengalami stenosis.…”

“…Kriteria eksklusi penelitian Khafaji dkk. 13 adalah pasien dengan gangguan fungsi ginjal dan memiliki keterbatasan penelitian karena jumlah sampel penelitian yang kecil hanya 34 pasien.…”