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Plasma endothelin-1-related peptides as the prognostic biomarkers for heart failure: A PRISMA-compliant meta-analysis

Cheng-Lin Zhang1, Shang Xie, Xue Qiao

  • 1Department of Physiology and Pathophysiology, Key Laboratory of Molecular Cardiovascular Science, Beijing Key Laboratory of Cardiovascular Receptors Research, Ministry of Education Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology Department of Geriatrics, Peking University Third Hospital, Beijing, China.

Medicine
|February 3, 2018
PubMed

Insights

High levels of endothelin-1 (ET-1), big ET-1, and C-terminal proET-1 (CT-proET-1) indicate a poor prognosis for heart failure (HF) patients. This meta-analysis confirms their association with increased mortality risk in HF populations.

Area of Science:

  • Cardiovascular Research
  • Biomarker Analysis
  • Clinical Epidemiology

Background:

  • Elevated plasma levels of endothelin-1 (ET-1), big ET-1, and C-terminal proET-1 (CT-proET-1) are frequently associated with poor prognosis in heart failure (HF).
  • Existing evidence on this association remains controversial, necessitating a comprehensive review.
  • This study addresses the debate by performing a meta-analysis of available research.

Purpose of the Study:

  • To systematically evaluate the association between plasma ET-1, big ET-1, and CT-proET-1 levels and prognosis in patients with heart failure.
  • To resolve conflicting findings in the literature regarding these biomarkers and adverse outcomes in HF.
  • To provide robust evidence on the predictive value of these biomarkers for HF mortality.

Main Methods:

  • A systematic literature search was conducted across Embase, PubMed, Ovid, and Web of Science databases up to June 28, 2017.
  • Hazard ratios (HRs) or risk ratios (RRs) and 95% confidence intervals (CIs) were extracted and synthesized using a random-effect model.
  • Heterogeneity was assessed using Cochran's Q test, and publication bias was evaluated via funnel plots and Egger's/Begg's regression tests.

Main Results:

  • The meta-analysis included 32 studies comprising 18,497 patients.
  • Increased circulating ET-1, big ET-1, and CT-proET-1 were significantly correlated with a higher risk of adverse outcomes (pooled RRs: 2.22, 2.47, and 2.27, respectively).
  • In analyses focused on death as the primary outcome, similar significant associations were observed for ET-1, big ET-1, and CT-proET-1.

Conclusions:

  • This meta-analysis provides strong evidence that elevated plasma concentrations of ET-1, big ET-1, and CT-proET-1 are associated with poor prognosis and increased mortality in heart failure patients.
  • These findings reinforce the role of the endothelin system as a significant predictor of adverse events in HF.
  • The results support the potential utility of these biomarkers in risk stratification for heart failure management.
Abstract

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