Endothelin-1 levels predict endothelial progenitor cell mobilization after acute myocardial infarction
Xavier Freixa1, Monica Masotti, Marta Palomo
1Cardiology Department, Hospital Clinic, University of Barcelona, Spain. freixa@clinic.ub.es
Insights
High endothelin-1 (ET-1) levels in ST-elevation myocardial infarction (STEMI) patients predict reduced endothelial progenitor cell (EPC) mobilization. ET-1 offers superior prognostic value compared to circulating endothelial cells (CEC) and EPCs.
Area of Science:
- Cardiovascular Medicine
- Endothelial Biology
- Biomarker Research
Background:
- Endothelin-1 (ET-1), circulating endothelial cells (CEC), and endothelial progenitor cells (EPC) are key regulators of endothelial function with significant cardiac implications post-myocardial infarction.
- The interrelationship between ET-1, CEC, and EPCs following ST-elevation myocardial infarction (STEMI) has not been previously investigated.
Purpose of the Study:
- To investigate the relationship between ET-1, CEC, and EPC concentrations in patients with STEMI.
- To assess the prognostic value of ET-1, CEC, and EPCs in STEMI patients.
Main Methods:
- Measurements of ET-1, CEC, and EPC levels were performed in 61 first-time STEMI patients.
- Blood samples were collected acutely (6-24h) and at 1 week post-admission.
- Study endpoints included reperfusion outcomes (angiography), left ventricular ejection fraction (echocardiography), and 30-day mortality.
Main Results:
- Elevated ET-1 plasma levels at admission were associated with lower EPC counts at 1 week (P=0.04).
- Higher ET-1 concentrations correlated with adverse clinical outcomes, including Killip class ≥2 (P<0.001), suboptimal reperfusion (TIMI flow <3, P=0.002; MBG <3, P=0.004), and increased 30-day mortality (P=0.005).
- Unlike ET-1, CEC and EPC counts did not show significant associations with these adverse outcomes.
Conclusions:
- In STEMI patients, elevated ET-1 levels upon admission are predictive of impaired EPC mobilization one week later.
- ET-1 demonstrates superior prognostic capability for clinical, angiographic, and echocardiographic outcomes in STEMI compared to CEC and EPC concentrations.
Introduction:
Endothelin-1 (ET-1), circulating endothelial cells (CEC) and endothelial progenitor cells (EPC) are well-known modulators of endothelial function with important cardiac effects after an acute myocardial infarction. However, the relationship between them has never been assessed. The objective of the present study was to establish the relationship between ET-1, CEC, and EPC concentrations after ST-elevation myocardial infarction (STEMI).
Methods:
Endothelin-1, CEC, and EPC levels were measured in 61 patients presenting with a first STEMI. Samples were withdrawn acutely 6-24h and 1week after admission. Assessments included reperfusion outcomes (angiography), left ventricular ejection fraction (echocardiography), and 30-day mortality.
Results:
Mean age was 60.6±12.6years and 45 (74%) were males. Higher ET-1 plasma levels were associated with lower EPC count after 1week (7.45±2.53pg/ml if EPCs in the first quartile vs 5.72±1.49pg/ml if EPCs in the fourth quartile; P=0.04). In contrast with CEC and EPC count, higher ET-1 concentrations on admission were associated with Killip≥2 (9.92±2.01pg/ml vs 7.32±2.13pg/ml; P<0.001), post-reperfusion thrombolysis in myocardial infarction (TIMI) <3 (8.65±2.86pg/ml vs 5.87±1.93pg/ml; P=0.002), myocardial blush grade (MBG) <3 (7.46±2.48pg/ml vs 5.99±2.01pg/ml; P=0.004) and higher 30-day mortality (10.29±2.02pg/ml vs 6.57±2.20pg/ml; P=0.005).
Conclusions:
In STEMI patients, high ET-1 levels on admission predict a lower EPC mobilization after 1week. Endothelin-1 provides better clinical, angiographic and echocardiographic information for prognosis than do CEC and EPC concentrations.
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