Plasma endothelin-1 level as a predictor for poor collaterals in patients with ≥ 95% coronary chronic occlusion
Plasma endothelin-1 level as a predictor for poor collaterals in patients with ≥ 95% coronary chronic occlusion
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DOI：
10.1016/j.thromres.2016.04.007
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发表时间：
2016-06-01
影响因子：
7.5
通讯作者：
Li, Jian-Jun
中科院分区：
文献类型：
--
作者：
Fan, Ying;Li, Sha;Li, Jian-Jun
背景：冠状动脉侧支循环（CCC）在心肌缺血损伤中起重要的保护作用。因此，研究影响CCC的因素具有重要的临床意义。本研究的目的是评估内皮素-1（ET-1）作为血管造影证实>= 95%冠状动脉occlusion.Methods：我们筛选了1038例冠状动脉造影检测到至少一条主要心外膜冠状动脉闭塞>= 95%的连续患者，作为CCC不良或良好的潜在预测因子。其中，663例患者被归类为CCC不良组，Rentrop 0-2级侧支循环，375例患者被归类为CCC良好组，Rentrop 3级。评估血浆ET-1水平与侧支循环状态的相关性。结果显示，CCC不良组患者血浆ET-1水平明显高于CCC良好组（0.59 +/- 0.48 vs. 0.39 +/- 0.32 pmol/L，p < 0.001），ET-1值随着Rentrop分级的下降而增加（趋势p < 0.001）。此外，多变量logistic回归分析显示ET-1与侧支循环状态之间存在独立相关性（CCC较差的比值比[95%CI]为2.27 [1.60-3.22]，p < 0.001）。此外，这种关联在两人身上都有意义。（CCC较差的比值比[95% CI]为3.18 [2.20-4.74]，p < 0.001）和女性进行性别特异性分析时，CCC较差的比值比[95% CI]为3.10 [1.36-7.85]，p = 0.011。血浆ET-1水平可能是预测≥ 95%冠状动脉慢性闭塞患者CCC程度的一个有用的、容易获得的指标。(C)2016爱思唯尔有限公司版权所有
Background: Coronary collateral circulation (CCC) plays an important role in protecting myocardium from ischemic damage. The studies on factors which impact on CCC might be of great clinical interest. The aim of the present study was to evaluate endothelin-1 (ET-1) as a potential predictor for poor or good CCC in patients with angiography-proven >= 95% coronary occlusion.Methods: We screened 1038 consecutive patients with >= 95% occlusion in at least one major epicardial coronary artery detected by coronary angiography. Of these, 663 patients were classified into the poor CCC group with Rentrop 0-2 grade collateral circulation and 375 patients into the good CCC group with Rentrop 3 grade. The association of plasma ET-1 levels with collateral status was assessed.Results: We found that patients in the poor CCC group had a higher ET-1 level than those in the good CCC group (0.59 +/- 0.48 vs. 0.39 +/- 0.32 pmol/L, p < 0.001), and the ET-1 values increased with the descent of the Rentrop grades (p for trend < 0.001). Moreover, multivariate logistic regression analysis revealed an independent association between ET-1 and collateral status (odds ratio [95% CI] for poor CCC 2.27 [1.60-3.22], p < 0.001). Additionally, the association presented significance in both men (odds ratio [95% CI] for poor CCC 3.18 [2.20-4.74], p < 0.001) and women (odds ratio [95% CI] for poor CCC 3.10 [1.36-7.85], p = 0.011) when the sex-specific analysis was performed.Conclusions: Plasma ET-1 level may be a useful, easily available marker for predicting the degree of CCC in patients with = 95% coronary chronic occlusion. (C) 2016 Elsevier Ltd. All rights reserved.