Role of Leptin as a Risk Factor and Prognostic Marker in Patients with Acute Coronary Syndrome

Abstract

Acute coronary syndromes (ACS) comprise a spectrum of clinical conditions, initiated by rupture of an atherosclerotic coronary plaque with overlying acute thrombosis. Diagnosis of acute coronary syndrome depends on a detailed clinical history, physical examination, immediate reading of a resting 12 lead electrocardiogram and biomarkers. ACS patients require rapid initiation of therapy aimed at achieving immediate reperfusion. Adipose tissue is an active endocrine organ which releases a large number of bioactive mediators known as adipokines (such as leptin and adiponectin), proinflammatory cytokines (IL-6 and CRP) and hypofibrinolytic factors (PAI-1). Leptin is a bioactive substance secreted by adipose tissue and exerts pleiotropic actions on glucose metabolism, may promote atherosclerosis and increase CV events. Leptin promotes vascular inflammation, enhancing platelet aggregation and arterial thrombosis, calcification of vascular cells, promote angiogenesis and increasing oxidative stress, and endothelial dysfunction and increases sympathetic activation, promoting atherosclerosis and its progression to clinical events.