Abstract 13035: High Plasma Levels of Endothelin-1 are Predictive of Future Cerebro- and Cardio-Vascular Events: a 20-Year Prospective Study
Background and purpose: Clinical and experimental evidence suggests that Endothelin-1 (Et-1) plays a crucial role in cardiac and vascular pathology. In the present study we investigated the prognostic significance of Et-1 for cerebro- and cardio-vascular outcome, in a follow-up of 20 years.
Methods: We studied 94 originally health subjects, referred to our Unit of Cardiovascular Prevention to evaluate the presence of asymptomatic carotid lesions. We subdivided these subjects into two groups, according to the plasma values of Et-1. Traditional cardiovascular risk factors were investigated, and by carotid ultrasound examination we distinguished between normal subjects and those with intima-media thickness or asymptomatic carotid plaque.
Results: Fatal or non-fatal events were registered in 41 subjects and significantly more in those with high (n=72) vs. low (n=22) Et-1 levels: 81% vs. 20%, p<0.0001. Fatal events were registered in 36 patients, while only 5 subjects had a non-fatal event. Subjects with high Et-1 levels had more fatal (p<0.0001) and non-fatal events (p=0.015) in relation to those with low Et-1 concentrations. Regarding specific events, subjects with high Et-1 levels had more fatal stroke (p<0.0001) and fatal acute myocardial infarction (p<0.05). Further, by logistic regression analysis we found that, among all evaluated baseline clinical and laboratory variables, hypertension (OR: 20.4 [3.3 to 127], p=0.001), high Et-1 concentrations (OR:1.4 [1.0 to 1.8], p= 0.02) and the presence of IMT or ACP (OR:3.7 [1.14 to 12.1, p=0.02) were independent predictors of future events.
Conclusions: Beyond traditional cardiovascular risk factors, plasma Et-1 levels significantly influenced cerebro- and cardio-vascular mortality.
- © 2012 by American Heart Association, Inc.