Leptin as predictor of cardiovascular events and high platelet reactivity in patients undergoing percutaneous coronary intervention.

Humans Percutaneous Coronary Intervention / adverse effects Platelet Aggregation Inhibitors Leptin Treatment Outcome Myocardial Infarction / epidemiology
Cardiovascular events Cardiovascular outcome Leptin Percutaneous coronary intervention Periprocedural myocardial infarction Platelet reactivity

Journal

Clinical nutrition ESPEN
ISSN: 2405-4577
Titre abrégé: Clin Nutr ESPEN
Pays: England
ID NLM: 101654592

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 25 05 2022
revised: 20 03 2023
accepted: 06 09 2023
medline: 11 12 2023
pubmed: 7 12 2023
entrez: 6 12 2023
Statut: ppublish

Résumé

Leptin is a hormone involved in the regulation of food intake. Previous studies suggested an interplay between leptin, platelet aggregation, and cardiovascular outcome but this issue was not investigated in vivo in patients treated with percutaneous coronary intervention (PCI). We designed a study to evaluate the possible relation between leptin, cardiovascular outcome, and platelet reactivity (PR) in patients undergoing PCI. 155 PCI patients had preprocedural measurements of PR and leptin plasma levels. The latter were assessed by ELISA. Hyperleptinemia was defined as leptin levels ≥14 ng/ml. PR was evaluated by the VerifyNowP2Y12 assay and expressed as P2Y12 reaction units (PRU). Patients were divided into three groups based on PR values and defined as low (LPR), normal (NPR), and high (HPR). Patients were followed for up 8 years. The primary endpoint was the incidence of Major Acute Cardiac Events (MACE) at long-term follow-up according to leptin groups. Secondary endpoints were the evaluation of leptin levels according to PR groups and the incidence of periprocedural myocardial infarction (PMI) according to leptin groups. Long-term follow-up was completed in 140 patients. Patients with hyperleptinemia experienced a higher MACE rate than the normoleptinemic group (HR 2.3; CI 95% 1.14-4.6, P = 0.02). These results remained unchanged after adjusting for Body Mass Index, hypertension, and gender. Leptin levels were significantly different among groups of PR (P = 0.047). Leptin levels were higher in the HPR group (12.61 ± 16.58 ng/ml) compared to the LPR group (7.83 ± 8.87 ng/ml, P = 0.044) and NPR group (7.04 ± 7.03 ng/ml, P = 0.01). The rate of PMI was higher in hyperleptinemia patients (15.1% vs. 6.5%, P = 0.22). This study suggests that high leptin levels are associated with a worse clinical outcome in patients undergoing PCI and with HPR. Further studies are needed to define better the pathophysiological pathways underlying this association.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Leptin is a hormone involved in the regulation of food intake. Previous studies suggested an interplay between leptin, platelet aggregation, and cardiovascular outcome but this issue was not investigated in vivo in patients treated with percutaneous coronary intervention (PCI). We designed a study to evaluate the possible relation between leptin, cardiovascular outcome, and platelet reactivity (PR) in patients undergoing PCI.
METHODS METHODS
155 PCI patients had preprocedural measurements of PR and leptin plasma levels. The latter were assessed by ELISA. Hyperleptinemia was defined as leptin levels ≥14 ng/ml. PR was evaluated by the VerifyNowP2Y12 assay and expressed as P2Y12 reaction units (PRU). Patients were divided into three groups based on PR values and defined as low (LPR), normal (NPR), and high (HPR). Patients were followed for up 8 years. The primary endpoint was the incidence of Major Acute Cardiac Events (MACE) at long-term follow-up according to leptin groups. Secondary endpoints were the evaluation of leptin levels according to PR groups and the incidence of periprocedural myocardial infarction (PMI) according to leptin groups.
RESULTS RESULTS
Long-term follow-up was completed in 140 patients. Patients with hyperleptinemia experienced a higher MACE rate than the normoleptinemic group (HR 2.3; CI 95% 1.14-4.6, P = 0.02). These results remained unchanged after adjusting for Body Mass Index, hypertension, and gender. Leptin levels were significantly different among groups of PR (P = 0.047). Leptin levels were higher in the HPR group (12.61 ± 16.58 ng/ml) compared to the LPR group (7.83 ± 8.87 ng/ml, P = 0.044) and NPR group (7.04 ± 7.03 ng/ml, P = 0.01). The rate of PMI was higher in hyperleptinemia patients (15.1% vs. 6.5%, P = 0.22).
CONCLUSIONS CONCLUSIONS
This study suggests that high leptin levels are associated with a worse clinical outcome in patients undergoing PCI and with HPR. Further studies are needed to define better the pathophysiological pathways underlying this association.

Identifiants

DOI: 10.1016/j.clnesp.2023.09.003 PMID: 38056992
pubmed: 38056992
pii: S2405-4577(23)01233-0
doi: 10.1016/j.clnesp.2023.09.003
pii:
doi:

Substances chimiques

Platelet Aggregation Inhibitors 0
Leptin 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

104-110

Informations de copyright

Copyright © 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest All authors have nothing to declare concerning the present manuscript.

Auteurs

Elisabetta Ricottini (E)

Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy. Electronic address: e.ricottini@policlinicocampus.it.

Laura Gatto (L)

Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy.

Annunziata Nusca (A)

Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.

Rosetta Melfi (R)

Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.

Fabio Mangiacapra (F)

Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Campus Bio-Medico University of Rome, Department of Medicine, Rome, Italy.

Marzia Albano (M)

Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.

Camilla Cavallaro (C)

Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.

Paolo Pozzilli (P)

Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Campus Bio-Medico University of Rome, Department of Medicine, Rome, Italy.

Germano Di Sciascio (G)

Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Campus Bio-Medico University of Rome, Department of Medicine, Rome, Italy.

Francesco Prati (F)

Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy; Centro per la Lotta Contro l'Infarto-CLI Foundation, Rome, Italy; Saint Camillus International Medical University, Rome, Italy.

Gian Paolo Ussia (GP)

Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Campus Bio-Medico University of Rome, Department of Medicine, Rome, Italy.

Francesco Grigioni (F)

Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Campus Bio-Medico University of Rome, Department of Medicine, Rome, Italy.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Leptin as predictor of cardiovascular events...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Procédures endovasculaires › Intervention coronarienne percutanée › Leptin as predictor of cardiovascular events...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents hématologiques › Antiagrégants plaquettaires › Leptin as predictor of cardiovascular events...
questionsmedicales.fr › Facteurs biologiques › Protéines et peptides de signalisation intercellulaire › Adipokines › Leptine › Leptin as predictor of cardiovascular events...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Leptin as predictor of cardiovascular events...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Nécrose › Infarctus › Infarctus du myocarde › Leptin as predictor of cardiovascular events...