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Hyperleptinemia as risk factor for high platelet reactivity and cardiovascular events in patients undergoing percutaneous coronary intervention
Authors : E Ricottini (Rome,IT), L Gatto (Rome,IT), R Melfi (Rome,IT), A Nusca (Rome,IT), C Cavallaro (Rome,IT), M Albano (Rome,IT), S Giannone (Rome,IT), G Patti (Rome,IT), F Prati (Rome,IT), P Pozzilli (Rome,IT), G Di Sciascio (Rome,IT)
E. Ricottini1
,
L. Gatto2
,
R. Melfi1
,
A. Nusca1
,
C. Cavallaro1
,
M. Albano1
,
S. Giannone1
,
G. Patti1
,
F. Prati2
,
P. Pozzilli3
,
G. Di Sciascio1
,
1University Campus Bio-Medico of Rome, Department of Cardiovascular Sciences - Rome - Italy
,
2Hospital San Giovanni Addolorata, Cardiology Unit - Rome - Italy
,
3University Campus Bio-Medico of Rome, Unit of Endocrinology - Rome - Italy
,
Background: Leptin is a hormone involved in the regulation of food intake. Previous investigations suggested a correlation between leptin and platelet aggregation. No data are available on relation between leptin and platelet reactivity (PR) and cardiovascular outcome in patients undergoing percutaneous coronary intervention (PCI).
Purpose: We investigate the role of leptin as predictor of high PR and cardiovascular events in patients undergoing PCI.
Methods: 155 PCI patients, enrolled in the study, had preprocedural measurement of PR and plasma leptin levels. These latter were assessed by ELISA. Hyperleptinemia was defined as leptin levels ≥14 ng/ml. PR was evaluated by the point-of-care VerifyNowP2Y12 assay and expressed as P2Y12 reaction units (PRU). Patients were divided in three groups based on PR: low (LPR), normal (NPR) and high (HPR). The follow up lasted 8 years. Primary endpoint was evaluation of leptin levels according to PR groups. Secondary endpoints were incidence of periprocedural myocardial infarction (PMI) and incidence of MACE at long-term follow-up according leptin group.
Results: Leptin plasma levels were significantly different among groups of PR (P=0.047). Leptin levels were significantly higher in HPR (12.61±16.58 ng/ml) compared to LPR (7.83±8.87 ng/ml, P=0.044) and NPR (7.04±7.03 ng/ml, P=0.01) group. Incidence of PMI in general population was 8%. Rate of PMI was higher among hyperleptinemic patients compared with the other group (15.1% vs 6.5%, P=0.22). Long-term follow-up was complete in 140 patients. Patients with hyperleptinemia experienced a significantly higher rate of MACE compared to the normoleptinemic group (HR 2.3; CI 95% 1.14–4.6, P=0.02). These results remained unchanged after adjusting for BMI, hypertension and sex.
Conclusions: The study suggests that high leptin levels are associated with HPR and with a worse clinical outcome in patients treated with clopidogrel undergoing PCI. Further studies are needed to better define the pathophysiological pathways underlying this association.
In line with the ESC mission, newly presented content is made available to all for a limited time (4 months for ESC Congress, 3 months for other ESC organised congresses). ESC Professional Members, Association Members (Ivory & above) benefit from year-round access to the resources of their respective Association, and to all content from previous editions of these congresses. Fellows of the ESC (FESC), and Professionals in training or under 40 years old, who subscribed to a Young Combined Membership package benefit from access to all ESC 365 content from all congresses, all editions, all year long. Find out more about ESC Memberships here.
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