Serum leptin and future cardiovascular events in patients with acute coronary syndrome

Background: Coronary artery disease (CAD) is a major cause of death worldwide. Acute coronary syndrome (ACS) encompasses acute myocardial infarction and unstable angina. Leptin is 16-kDa hormone with pleiotropic actions in multiple organ systems. There is increasing interest in the potential role of leptin in the cardiovascular system. Studies comparing levels of leptin in patients with ACS to healthy matched controls, especially in the developing countries, are limited and rare. Aim of Study: This study was conducted to study leptin in ACS patients, comparing the results to a healthy matched control group and correlating the levels to the in-hospital outcome. Patients and Methods: The study was conducted at Cairo University Hospital. Serum leptin levels were studied in 50 patients admitted with the ACS (Group-I) compared to matched control group (Group-II) and correlating these levels to hospital morbidity and mortality. Diagnostic coronary artery catheterization was done to patients through femoral artery access to assess the severity and extent of CAD. Results: Serum leptin levels were significantly higher in ACS group compared to the normal controls, (P = 0.001). Although not statistically significant leptin levels were increased in eventful compared to the uneventful group. Conclusion: In patients with ACS, persistent elevation of serum leptin during serial measurements was invariably associated with worse in-hospital outcome. Positive correlation of serum leptin levels with other chronic inflammatory state such as obesity, hypertension, and female gender supports the hypothesis that leptin is a determinant of CAD possibly through its proinflammatory action.