title: Plasma endothelin-1 level is a predictor of 10-year mortality in a general population: the Tanushimaru study.
abstract: BACKGROUND
  Endothelin-1 (ET-1) is a potent vasoconstrictor and an elevated plasma level is a prognostic marker in patients with cardiovascular diseases and/or malignancies. We hypothesized that an elevated plasma level might be a prognostic marker even in subjects without apparent cardiovascular disease or malignancy at baseline.
  
  
  RESULTS
  We measured plasma ET-1 levels in 1,440 healthy subjects over 40 years of age (580 men, 860 women) who were periodically followed for 10 years. The follow-up rate was 96.8%. Baseline plasma ET-1 levels were categorized into quartiles. Baseline plasma ET-1 levels were significantly associated with age, blood pressure, high-density lipoprotein-cholesterol, renal function, uric acid and all-cause death, but not with cardiovascular or cancer death. Kaplan-Meier curves demonstrated that all-cause mortality was significantly higher in the highest quartile of ET-1 than in the lowest quartile. Cox proportional hazards regression analysis demonstrated that ET-1 was an independent predictor of all-cause death [hazard ratio: 1.11, 95% confidence interval (CI) 1.01-1.23 per 1 pg/ml difference]. The hazard ratio of all-cause death in the highest quartile of plasma ET-1 (≥5.9 pg/ml) vs. the lowest quartile after adjusting for confounding factors was 1.54 (95% CI 1.09-2.20).
  
  
  CONCLUSIONS
  The plasma ET-1 level may be a predictor of all-cause death in a healthy population.
authors.affiliation: Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Yokoi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Adachi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hirai
authors.forename: Mika
authors.initials: M
authors.lastname: Enomoto
authors.forename: Ako
authors.initials: A
authors.lastname: Fukami
authors.forename: Kinuka
authors.initials: K
authors.lastname: Ogata
authors.forename: Eri
authors.initials: E
authors.lastname: Tsukagawa
authors.forename: Akiko
authors.initials: A
authors.lastname: Kasahara
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Imaizumi
mesh_terms: D000368:Aged; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000208:ethnology / Q000401:mortality*; D002423:Cause of Death; D016009:Chi-Square Distribution; D015986:Confounding Factors, Epidemiologic; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000097:blood* / Q000208:ethnology / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D019332:Endothelin-1