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Admission Plasma Leptin Level Strongly Correlates With the Success of Thrombolytic Therapy in Patients With Acute Myocardial Infarction

Department of Cardiology, Ankara, Turkey, dramasyali{at}yahoo.com

Kudret Aytemir, MD, FESC

Department of Cardiology, Hacettepe University School of Medicine, Ankara, Turkey

Sedat Kose, MD

Department of Cardiology, Ankara, Turkey

Ayhan Kilic, MD

Department of Cardiology, Ankara, Turkey

Gulcan Abali, MD

Department of Cardiology, Hacettepe University School of Medicine, Ankara, Turkey

Atila Iyisoy, MD

Department of Cardiology, Ankara, Turkey

Hurkan Kursaklioglu, MD

Department of Cardiology, Ankara, Turkey

Mustafa Turan, MD

Department of Internal Medicine, Gulhane Military Medical School, Ankara, Turkey

Necati Bingol, MD

Department of Biochemistry, Bayindir Medical Center, Ankara, Turkey

Ersoy Isik, MD

Department of Cardiology, Ankara, Turkey

Ertan Demirtas, MD, FACC

Department of Cardiology, Ankara, Turkey

Obesity-associated alterations in coagulation and fibrinolytic factors in favor of thrombosis are well known. Observations suggest that leptin, a recently discovered obesity gene product, in addition to being a satiety factor, induces platelet aggregation, accelerates formation of firm thrombi, and is associated with abnormal fibrinolysis. The authors studied the influence of plasma leptin concentrations on admission within 6 hours of acute myocardial infarction (MI) on the outcome of thrombolytic therapy (TT). Forty-one patients with acute MI who underwent TT were enrolled into the study. Levels of plasma leptin were determined with radioimmunoassay method in samples obtained just before initiation of TT. Patients were initially classified according to the admission plasma leptin concentrations, and it was observed that failure of reperfusion therapy with streptokinase was significantly higher in patients with admission plasma leptin concentrations 14 ng/mL (group 2) as compared to patients with admission plasma leptin concentrations <14 ng/mL (group 1). Final failure of TT, identified both by reinfarction and absence of early reperfusion as assessed noninvasively, was observed in 11 patients (39%) in group 1 and in 10 patients (77%) in group 2 (p=0.025). Left ventricular ejection fraction was slightly but significantly higher in group 1 than in group 2 (p=0.031). High plasma leptin concentrations on admission in patients within 6 hours after the onset of acute MI are associated with less TT efficacy. The authors suggest that admission leptin levels may play a role in the management of patients with acute MI.

Angiology, Vol. 57, No. 6, 671-680 (2007)
DOI: 10.1177/0003319706295204


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