title: Plasma big endothelin-1 level and the severity of new-onset stable coronary artery disease.
abstract: OBJECTIVE
  To investigate the usefulness of the plasma big endothelin-1 (big ET-1) level in predicting the severity of new-onset stable angiography-proven coronary artery disease (CAD).
  
  
  METHODS
  A total of 963 consecutive stable CAD patients with more than 50% stenosis in at least one main vessel were enrolled. The patients were classified into the three groups according to the tertile of the Gensini score (GS, low GS ＜20, n=300; intermediate GS 20-40, n=356 and high GS ＞40, n=307), and the relationship between the big ET-1 level and GS was evaluated.
  
  
  RESULTS
  The plasma levels of big ET-1 increased significantly in association with increases in the GS tertile (p=0.007). A multivariate analysis suggested that the plasma big ET-1 level was an independent predictor for a high GS (OR=2.26, 95%CI: 1.23-4.15, p=0.009), and there was a positive correlation between the big ET-1 level and the GS (r=0.20, p=0.000). The area under the receiver operating characteristic curve (AUC) for the big ET-1 level in predicting a high GS was 0.64 (95% CI 0.60-0.68, p=0.000), and the optimal cutoff value for the plasma big ET-1 level for predicting a high GS was 0.34 fmol/mL, with a sensitivity of 62.6% and specificity of 60.3%. In the high-big ET-1 level group (≥0.34 fmol/mL), there were significantly increased rates of three-vessel disease (43.6% vs. 35.4%, p=0.017) and a high GS [31 (17-54) vs. 24 (16-44), p=0.001] compared with that observed in the low-big ET-1 level group.
  
  
  CONCLUSIONS
  The present findings indicate that the plasma big ET-1 level is a useful predictor of the severity of new-onset stable CAD associated with significant stenosis.
authors.affiliation: Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiology, The Central Hospital of Wuhan, Wuhan, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.forename: Man-Hua
authors.initials: MH
authors.lastname: Chen
authors.forename: Yuan-Lin
authors.initials: YL
authors.lastname: Guo
authors.forename: Cheng-Gang
authors.initials: CG
authors.lastname: Zhu
authors.forename: Rui-Xia
authors.initials: RX
authors.lastname: Xu
authors.forename: Qian
authors.initials: Q
authors.lastname: Dong
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Li
mesh_terms: D017668:Age of Onset; D015415:Biomarkers / Q000097:blood*; D002681:China; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000097:blood / Q000175:diagnosis*; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D019332:Endothelin-1