Leptin levels are not affected by enalapril treatment after an uncomplicated myocardial infarction, but associate strongly with changes in fibrinolytic variables in men

Figures & data

Table 1. Subject characteristics at baseline.

	Men	Range	IQR	Women	Range	IQR	p-Value
N	46			37
Age (years)	65	43	16	72	27	10	.002
BMI (kg/m^2)	26.4	16.1	3.1	25.7	16.2	5.7	.71
Smoker (%)	15.2			8.1			.33
Diabetes (%)	6.5			.0			.08
Hypertension (%)	32.6			56.8			.03
Thrombolytic treatment (%)	50.0			40.5			.40
History of coronary by-pass (%)	37.0			32.4			.67
β-Blocker (%)	71.7			75.7			.69
ASA (%)	89.1			89.2			.99
Statins (%)	17.4			27.0			.30
Active treatment with ACE inhibitor (%)	41.3			56.8			.17
Time-lag between AMI and study-start (months)	10.0	42	8	19.0	44	19	<.001

Numbers shown are proportions and medians with ranges and IQR.

Differences between groups tested with Student's t-test or Mann–Whitney tests when appropriate.

IQR: interquartile range.

Table 2. Subject characteristics at baseline and changes during the year.

Variable	Time point	Men	95% CI	p^2	Women	95% CI	p^2	p^1
Systolic blood pressure (mmHg)	Baseline	145.6	138.4–152.8		158.9	151–166.9		.02
	10 days	134.1	127.7–140.4		146.8	139.6–154		.01
	6 months	133.6	127.5–139.6		149.5	142.6–156.4		.001
	12 months	145.4	138.6–152.2	<.001	159.2	151.2–167.1	.001	.01
Diastolic blood pressure (mmHg)	Baseline	84.3	81.3–87.4		85.1	81.7–88.5		.74
	10 days	76.4	73.3–79.6		77.1	73.5–80.6		.79
	6 months	77.2	74–80.5		76.1	72.4–79.8		.64
	12 months	82.8	80–85.6	<.001	82.6	79.4–85.9	<.001	.96
Total cholesterol (mmol/L)	Baseline	6.5	6.1–6.8		7.2	6.8–7.7		.01
	12 months	5.9	5.5–6.2	<.001	6.5	6.1–6.9	.002	.03
HDL cholesterol (mmol/L)	Baseline	1.1	1.01–1.18		1.27	1.17–1.36		.008
	12 months	1.2	1.02–1.39	<.001	1.47	1.26–1.69	.15	.06
Triglycerides (mmol/L)*	Baseline	1.6	1.5–1.8		1.7	1.5–1.9		.5
	12 months	1.9	1.6–2.1	.007	1.9	1.6–2.2	.04	.82
Leptin (ng/mL)*	Baseline	5.8	5.1–6.5		17.6	15.2–20.4		<.001
	10 days	5.8	5–6.6		16.9	14.5–19.8		<.001
	6 months	5.9	5.2–6.9		17.6	14.9–20.8		<.001
	12 months	6.5	5.5–7.6	.04	19.6	16.2–23.7	.09	<.001
tPA mass (µg/L)*	Baseline	11.2	10–12.5		13.3	11.7–15.1		.05
	10 days	10.3	9.2–11.5		12.3	10.9–13.9		.03
	6 months	10.8	9.7–12		11.7	10.3–13.2		.34
	12 months	11.7	10.6–13	.005	12.8	11.4–14.4	.12	.26
PAI-1 mass (µg/L)*	Baseline	26.1	22.1–30.8		25.4	21.2–30.5		.83
	10 days	21	17.7–24.9		23.2	19.3–27.9		.43
	6 months	17	13.9–20.8		18	14.2–22.7		.73
	12 months	21.5	18–25.7	<.001	19.1	15.5–23.5	.02	.4
tPA–PAI complex (µg/L)*	Baseline	4.2	3.6–5		5.4	4.4–6.6		.08
	10 days	3.9	3.3–4.7		4.7	3.8–5.8		.2
	6 months	3.9	3.2–4.6		4.9	4–6		.07
	12 months	4.5	3.9–5.3	.02	5.9	4.9–7.1	.03	.04

Adjusted (treatment allocation, and age and BMI at baseline) means (geometric*) with 95% confidence intervals (CI).

Differences between men and women at each time point tested with an ANOVA (p¹), and overall time effects between baseline and 12 months with a repeated assessment analysis (p²), all adjusted for age, BMI and treatment allocation.

Table 3. Multivariate linear regression models testing associations between changes in leptin and fibrinolytic variables.

	tPA mass change				PAI-1 mass change				tPA–PAI complex change
	β	SE	St β	p	β	SE	St β	p	β	SE	St β	p
All men
Leptin change	0.435	0.122	0.542	.001	0.747	0.250	0.433	.006	0.550	0.170	0.491	.003
Treatment	−0.172	0.082	−0.324	.044	−0.585	0.168	−0.513	.002	−0.100	0.114	−0.136	.386
Men on placebo
Leptin change	0.709	0.147	0.896	<.001	0.764	0.367	0.511	.053	0.698	0.277	0.592	.021
Men on enalapril
Leptin change	0.348	0.279	0.425	.241	0.907	0.554	0.520	.136	0.583	0.322	0.555	.103
All women
Leptin change	−0.166	0.184	−0.179	.377	−0.125	0.396	−0.072	.755	−0.175	0.292	−0.125	.554
Treatment	−0.118	0.123	−0.195	.346	−0.057	0.265	−0.050	.831	0.113	0.195	0.123	.568
Women on placebo
Leptin change	0.096	0.261	0.199	.726	−0.627	0.440	−0.669	.203	0.326	0.400	0.389	.446
Women on enalapril
Leptin change	−0.325	0.365	−0.217	.394	0.557	0.746	0.202	.474	−0.218	0.507	−0.108	.676

Multivariate linear regression with fibrinolytic variables as dependent variables, and stratified for sex and treatment allocation.

Delta-values of ln-transformed variables (over 1 year) used for leptin, tPA mass, PAI-1 mass and tPA–PAI complex.

Treatment: 1 = placebo and 2 = enalapril. BMI and age tested as tertiles with sex-specific cut-off.

Cut-off points (men;women): BMI <25.4;<24.2, 25.4–27.1; 24.2–28.4; and 27.1+;28.4+, and for age <59;<68, 59–70;68–74, and 70+;74+.

β: regression coefficients; SE(β): standard error of β; St β: standardized regression coefficients.