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Time course of endothelin-1 plasma level in patients with acute coronary syndromes
Insights
Plasma endothelin-1 levels are elevated in patients with unstable angina pectoris and myocardial infarction. This increase in endothelin-1 persists for several days after symptom onset, indicating its role in cardiovascular conditions.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Clinical Research
Background:
- Elevated plasma endothelin-1 is linked to cardiovascular diseases like unstable angina and myocardial infarction.
- Understanding the temporal release of endothelin-1 is crucial for assessing its role in acute coronary syndromes.
Purpose of the Study:
- To investigate the time course of endothelin-1 release in patients diagnosed with unstable angina pectoris.
- To determine the relationship between endothelin-1 levels and the development of myocardial infarction and coronary artery occlusion.
Main Methods:
- Studied 32 patients with unstable angina pectoris (Group A) and 14 with stable angina pectoris (Group B).
- Measured plasma endothelin-1 levels via coronary angiography.
- Analyzed endothelin-1 levels in relation to subsequent myocardial infarction, coronary occlusion, symptom persistence, and treatment response.
Main Results:
- Significantly higher plasma endothelin-1 levels were observed in unstable angina patients (10.2 ± 5.3 pg/ml) compared to stable angina controls (6.0 ± 3.1 pg/ml) (p < 0.01).
- No significant differences in endothelin-1 levels were found based on subsequent myocardial infarction, coronary occlusion, symptom duration, or treatment outcomes within the unstable angina group.
- Elevated endothelin-1 levels persisted for over 96 hours post-chest pain episode.
Conclusions:
- Plasma endothelin-1 is elevated in patients with unstable angina pectoris and myocardial infarction.
- The elevated endothelin-1 levels in unstable angina persist for several days, suggesting a sustained pathophysiological role.
- Endothelin-1 levels did not correlate with specific clinical outcomes or the timing of blood sampling in this cohort.
Abstract:
An elevated plasma level of endothelin-1 was reported in several cardiovascular conditions including unstable angina pectoris and myocardial infarction. The present study was designed to evaluate the time course of the endothelin-1 release in unstable angina pectoris and to assess its relationship to the development of myocardial infarction and coronary vessel occlusion. The cohort studied included 32 patients with the clinical diagnosis of unstable angina pectoris who had been admitted to the coronary care unit and subsequently underwent coronary angiography (group A). Fourteen patients with chronic stable angina pectoris referred to routine diagnostic coronary angiography served as the control group (group B). A significant difference in the endothelin-1 plasma level was found between both groups, the values being 10.2 +/- 5.3 and 6.0 +/- 3.1 pg/ml (p < 0.01), respectively. There were, however, no significant differences between the following subdivisions of group A: patients with and without subsequent myocardial infarction; those with angiographically documented occlusion of at least one major branch of the coronary artery and no occlusion; and finally, those with persisting symptoms of angina pectoris and with favorable response to treatment. Neither was there any difference found among the subgroups differing in the time interval between the onset of chest pain and blood sampling. The time course of endothelin plasma concentrations showed elevated values lasting for more than 96 h after the index episode of prolonged chest pain. No correlation with the subsequent clinical course could be inferred. Thus, plasma endothelin level was elevated in patients with unstable angina pectoris and myocardial infarction and the increase persisted for several days after the onset of symptoms.