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Plasma immunoreactive endothelin concentration correlates with severity of coronary artery disease in patients with
O A Salomone1, P M Elliott, R Calviño
1Department of Cardiological Sciences, St. George's Hospital Medical School, London, England.
Insights
Plasma endothelin levels are elevated in patients with chronic stable angina, particularly those with severe coronary artery disease. This indicates a correlation between endothelin concentration and the extent of atherosclerosis.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Medical Research
Background:
- Plasma endothelin-1 is elevated in unstable coronary syndromes and advanced atherosclerosis, suggesting a role in atherogenesis.
- The relationship between plasma endothelin and coronary artery disease in stable angina remains debated.
Purpose of the Study:
- To investigate the correlation between plasma immunoreactive endothelin concentration and the severity/extent of coronary atherosclerosis in patients with stable angina.
- To compare endothelin levels in patients with varying degrees of coronary artery disease and healthy controls.
Main Methods:
- Prospective study of 90 patients with exertional chest pain undergoing coronary angiography and 49 control subjects.
- Coronary angiography assessed stenosis extent, severity, and morphology; plasma endothelin measured via radioimmunoassay.
Main Results:
- Plasma endothelin was significantly higher in patients (7.29 pg/ml) than controls (3.48 pg/ml).
- Endothelin levels increased with disease severity, being highest in patients with atheroma in multiple territories (9.43 pg/ml).
- Plasma endothelin correlated with stenosis degree (r=0.25) and number of severe stenoses (r=0.36), and was highest in total occlusions.
Conclusions:
- Plasma immunoreactive endothelin is elevated in chronic stable angina patients.
- Higher endothelin levels are associated with severe coronary stenoses and total occlusions.
- Endothelin may serve as a biomarker for coronary atherosclerosis severity.
Objectives:
The present study tested the hypothesis that plasma immunoreactive endothelin concentration correlates with the severity and extent of coronary atherosclerosis.
Background:
Plasma endothelin-1 concentration is increased in patients with unstable coronary syndromes and advanced atherosclerosis. This finding, together with other clinicopathologic observations, suggests that endothelins may participate in the atherogenic process. However, the relation between plasma immunoreactive endothelin and coronary artery disease in patients with stable angina pectoris remains controversial.
Methods:
Ninety consecutive patients undergoing coronary angiography for the investigation of exertional chest pain and 49 normal control subjects were prospectively studied. Eleven patients had normal coronary angiographic findings (group I), 65 had coronary artery stenoses (group II), and 14 had coronary artery disease plus symptoms indicating atheroma in other vascular territories (group III). Computerized angiography was used to determine the extent, severity and morphology of coronary stenoses. Plasma immunoreactive endothelin was measured by radioimmunoassay.
Results:
Mean (+/- SD) plasma endothelin concentration (pg/ml) was significantly higher in patients than in control subjects (7.29 +/- 4.07 vs. 3.48 +/- 1.29, p < 0.0001). Endothelin levels were higher in patients of group III than in those of groups II and I (9.43 +/- 5.48, 7.20 +/- 3.72 and 4.94 +/- 2.89, respectively, p = 0.02). In patients of group II, plasma endothelin correlated with the maximal degree of stenosis in each patient (r = 0.25, p = 0.04) and with the number of stenoses with > or = 70% diameter narrowing (r = 0.36, p = 0.002). The highest plasma endothelin levels were found in patients with total occlusions (8.65 +/- 3.78 vs. 6.46 +/- 3.51 p = 0.02).
Conclusions:
Plasma immunoreactive endothelin concentration is increased in patients with chronic stable angina. The higher levels occur in patients with severe stenoses and total coronary occlusion.