Introduction: Elevated serum leptin levels are associated with cardiovascular events. We investigated the role of serum leptin in patients undergoing carotid endarterectomy (CEA). Methods: A total of 74 patients (55 men; 38 symptomatic and 36 asymptomatic; mean age 66.9 ± 8.2 years) undergoing CEA for >70% carotid artery stenosis were enrolled. Results: Serum leptin levels were lower in symptomatic compared with asymptomatic patients (7.1 ± 1.3 vs 14.4 ± 4.7 ng/dL; P < .001). Interleukin-6 (IL-6) levels were higher in symptomatic compared with asymptomatic patients (4.3 ± 1.7 vs 3.3 ± 1.1 pg/dL; P = .017). Symptomatic patients had more intense macrophage accumulation (0.7% ± 0.1% vs 0.3% ± 0.1%; P < .001). Serum leptin and serum IL-6 levels were independently associated with the presence of symptoms in multivariate analysis. Conclusion: Serum leptin levels were decreased in symptomatic carotid artery disease. This finding requires further investigation in larger studies.
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