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January 1, 2005Circulation JournalOpen Access

Clinical Significance of Acute-Phase Endothelin-1 in Acute Myocardial Infarction Patients Treated With Direct Coronary Angioplasty

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Why the study?

Does high acute-phase plasma endothelin-1 predict worse clinical outcomes and left ventricular systolic dysfunction in patients with acute myocardial infarction treated with primary PCI?

Population

110 consecutive patients with first acute myocardial infarction successfully reperfused by primary…

Comparison

High plasma endothelin-1 concentration measured… vs Low plasma endothelin-1 concentration measured…

Design

Cohort

Follow-up

3 months for clinical outcomes, 21±8 days for LV function

Key result

High acute-phase plasma endothelin-1 concentrations (≥2.9 pg/ml) in acute myocardial infarction patients were associated with significantly higher rates of cardiac death (13% vs 0%) and poorer left ventricular systolic function.

Authors

TKToshiro KatayamaKYKatsusuke YanoHNHiroshi Nakashima

Discussion

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Member takes

Overview

High ET-1 may flag higher-risk AMI patients; leaves open incremental prognostic value and therapeutic implications.

Study Design

Type

Cohort (n=110)

Multicenter

Yes

Structured PICO

Does high acute-phase plasma endothelin-1 predict worse clinical outcomes and left ventricular systolic dysfunction in patients with acute myocardial infarction treated with primary PCI?

P
Population
110 consecutive patients (mean age 68, 28% female) with a first acute myocardial infarction successfully reperfused by primary percutaneous coronary intervention, followed for 3 months.
E
Exposure
High plasma endothelin-1 (ET-1) concentration (≥ 2.90 pg/ml) measured 24 hours after AMI onset
C
Comparator
Low plasma endothelin-1 (ET-1) concentration (< 2.90 pg/ml) measured 24 hours after AMI onset
O
Outcome
Relationship between plasma concentrations of endothelin (ET)-1 and clinical outcome (including mortality) and left ventricular (LV) systolic functionhard clinical

Main Result

Absolute Event Rate: 13% vs 0%

p-value: p=<0.01

Limitations

  • Small sample size requiring confirmation in a large-scale trial
  • Exclusion of patients with renal failure may have introduced bias
  • Exclusion of patients who died within 24 hours of symptom onset may have constituted bias
  • Small size of the sample population
  • Exclusion of patients with renal failure, which may have introduced bias
  • Exclusion of patients who died within 24h of the onset of symptoms of AMI, which may have constituted bias

Cite This Study

Katayama et al. (2005) conducted a cohort in Acute Myocardial Infarction (n=110). High plasma endothelin-1 (ET-1) concentration (≥2.9 pg/ml) vs. Low plasma ET-1 concentration (<2.9 pg/ml) was evaluated on Cardiac death (p=<0.01). High acute-phase plasma endothelin-1 concentrations (≥2.9 pg/ml) in acute myocardial infarction patients were associated with significantly higher rates of cardiac death (13% vs 0%) and poorer left ventricular systolic function.

synapsesocial.com/papers/6a945f87bba503d12d31a89bhttps://doi.org/10.1253/circj.69.654
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