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.
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?
Cohort (n=110)
Yes
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?
Answers are grounded in this paper and cite their sources.
Cohort study demonstrates elevated acute-phase endothelin-1 correlates with adverse cardiac events and dysfunction in myocardial infarction patients, highlighting its prognostic value.
BACKGROUND: The aim of the present study was to investigate the relationship between plasma concentrations of endothelin (ET)-1 and clinical outcome (including mortality) and left ventricular (LV) systolic function in acute myocardial infarction (AMI). METHODS AND RESULTS: The study group comprised 110 consecutive first-AMI patients who were successfully reperfused by primary coronary intervention. Plasma ET-1 concentrations were evaluated 24 h from onset and the patients were divided into 2 groups according to the median value, either a high group (H group: > or = 2.90 pg/ml plasma ET-1; n = 55) or low group (L group: < 2.90 pg/ml plasma ET-1; n = 55). Major complications and LV systolic function were monitored in the 2 groups. Both highly sensitive C-reactive protein (hs-CRP) and brain natriuretic peptide (BNP) showed a significant positive correlation with ET-1 (BNP: r = 048, p < 0.0001, hs-CRP: r = 0.43, p < 0.001). Chronic stage left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume index (LVEDVI) were significantly poorer in the H group (LVEF: 51+/-15% vs 60+/-13%, p = 0.003, LVEDVI: 74+/-19 ml/m2 vs 66+/-14 ml/m2, p < 0.05). There were significantly more major complications in the H group than in the L group (cardiogenic shock: 18% vs 5%, p = 0.04; cardiac death: 13% vs 0%, p < 0.01). CONCLUSIONS: In the setting of AMI, plasma ET-1 concentrations may be closely related to LV systolic dysfunction and poor patient outcome, including mortality.
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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.
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