title: Relationship between serum endothelin-1 level and spontaneous reperfusion in patients with acute myocardial infarction.
abstract: OBJECTIVE
  Spontaneous reperfusion (SR) was associated with better clinical outcomes and lower incidence of major adverse cardiovascular events. Endothelin-1 (ET-1) is a potent endothelium-derived vasoconstrictor peptide and elevated systemic ET-1 levels predict a poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the relationship between systemic ET-1 plasma levels and SR in a group of STEMI patients treated with a primary percutaneous coronary intervention (PCI).
  
  
  RESULTS
  We measured ET-1 levels acutely (within the first 6 h) in 33 STEMI patients with SR and 45 STEMI patients with non-SR presenting with their first STEMI who underwent primary PCI. Blood samples for ET-1 plasma level measurement were drawn after vascular puncture before angiography in the catheterization laboratory from the peripheral vein.The mean age of the patients was 56.1±13.3 years in the SR group and 57.4±11.4 years in the non-SR group. The circulating level of ET-1 was considerably higher in the non-SR patients than in the SR patients (0.81±0.2, 1.0±0.3, P=0.004). On multivariable logistic regression analysis, the ET-1 level was the only significant predictor of SR (P=0.01).The receiver operating characteristic curve analysis showed that the ET-1 level at admission is an indicator of SR, with an area under the curve of 0.62.
  
  
  CONCLUSIONS
  This study shows that in patients admitted with ST-elevation acute myocardial infarction, ET-1 plasma levels are related to angiographic SR before primary PCI.
authors.affiliation: aDepartment of Cardiology, Istanbul University Institute of Cardiology bDepartment of Biochemistry, Istanbul University Medical Faculty, Istanbul, Turkey.
authors.forename: Kadriye Orta
authors.initials: KO
authors.lastname: Kilickesmez
authors.forename: Gülsüm
authors.initials: G
authors.lastname: Bingöl
authors.forename: Leyla
authors.initials: L
authors.lastname: Bulut
authors.forename: Umit Yaşar
authors.initials: UY
authors.lastname: Sinan
authors.forename: Okay
authors.initials: O
authors.lastname: Abaci
authors.forename: Murat
authors.initials: M
authors.lastname: Ersanli
authors.forename: Tevfik
authors.initials: T
authors.lastname: Gurmen
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D012372:ROC Curve; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D015415:Biomarkers; D019332:Endothelin-1