Related Experiment Video
Updated: Feb 22, 2026
Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
Plasma big endothelin-1 and stent thrombosis: An observational study in patients undergoing percutaneous coronary
Yan Chen1, Jian-Xin Li2, Ying Song1
1Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Insights
High big endothelin-1 (ET-1) levels predict stent thrombosis (ST) after coronary stenting. This risk is particularly elevated in patients with acute coronary syndrome, highlighting ET-1 as a key biomarker.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Interventional Cardiology
Background:
- Stent thrombosis (ST) is a serious complication following percutaneous coronary intervention.
- Endothelin-1 (ET-1) is implicated in endothelial dysfunction and clot formation.
- The predictive value of big ET-1 for ST remains unestablished.
Purpose of the Study:
- To investigate whether plasma big ET-1 levels can predict stent thrombosis in patients receiving coronary stents.
- To assess the association between big ET-1 levels and ST incidence post-stenting.
Main Methods:
- Prospective enrollment of 8106 patients undergoing successful coronary stent implantation (January 2013 - December 2013).
- Stratification of patients into three groups based on admission plasma big ET-1 levels.
- Two-year follow-up to assess the incidence of definite and probable ST.
Main Results:
- The overall incidence of ST at 2 years was 0.84%.
- ST incidence was significantly higher in the high big ET-1 group (1.48%) compared to the low big ET-1 group (0.56%) (log-rank p=0.001).
- High big ET-1 was an independent predictor of ST (adjusted HR 2.06; p=0.017) and strongly associated with ST in acute coronary syndrome patients (adjusted HR 2.29; p=0.041).
Conclusions:
- Plasma big ET-1 level is a significant independent predictor of ST in patients with coronary stents.
- Elevated big ET-1 levels are particularly associated with increased ST risk in the acute coronary syndrome population.
Introduction:
Stent thrombosis (ST) is a rare but catastrophic complication of percutaneous coronary intervention, leading to poor prognosis. Endothelin-1 (ET-1) plays an important role in endothelial dysfunction and thrombogenesis. However, the impact of big ET-1 level on ST in patients with coronary stenting is unknown. We aimed to evaluate big ET-1 level as a potential predictor of ST in patients undergoing percutaneous coronary intervention.
Materials And Methods:
From January 2013 to December 2013, 8106 consecutive patients underwent successful coronary stent implantation and were prospectively enrolled in this study. Patients were stratified into three groups based on plasma big ET-1 level at admission.
Results:
The incidence of definite and probable ST at 2years postoperatively was 0.84%; ST incidence was lowest in the low big ET-1 group (0.56%), highest in the high big ET-1 group (1.48%), and intermediate in the medium big ET-1 group (0.74%, log-rank p=0.001). Compared with the low big ET-1 group, the multivariate-adjusted hazard ratio (HR) for ST in the high big ET-1 group was 2.06 (95% confidence interval (CI) 1.14-3.73, p=0.017). In subgroup analyses, high big ET-1 level was independently associated with ST in patients with acute coronary syndrome (HR 2.29, 95% CI 1.03-5.06, p=0.041), but not in those with stable coronary artery disease (p=0.331), and tended to be associated with older age.
Conclusions:
Plasma big ET-1 level is a valuable independent predictor of ST in patients with coronary stents, especially in the acute coronary syndrome population.
More Related Videos
Related Concept Videos
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...