6533b828fe1ef96bd128853a
RESEARCH PRODUCT
High plasma levels of endothelin-1 enhance the predictive value of preclinical atherosclerosis for future cerebrovascular and cardiovascular events: a 20-year prospective study
Rizzo ManfrediAngela SansoneClaudio PerniceFrancesco Paolo GuarneriSalvatore NovoNovo Giuseppinasubject
Carotid Artery DiseasesMalePredictive Value of TestCarotid Intima-Media ThicknessRisk FactorsCardiovascular Diseasefollow-upProspective Studiescardiovascular events; cerebrovascular events; endothelin-1; follow-up; Adult; Aged; Asymptomatic Diseases; Biomarkers; Cardiovascular Diseases; Carotid Artery Diseases; Carotid Intima-Media Thickness; Cerebrovascular Disorders; Endothelin-1; Female; Follow-Up Studies; Humans; Male; Middle Aged; Plaque Atherosclerotic; Predictive Value of Tests; Prognosis; Prospective Studies; Risk Factors; Cardiology and Cardiovascular Medicine; Medicine (all)Prospective cohort studyEndothelin-1Medicine (all)Follow up studiesGeneral MedicineMiddle AgedPrognosiscardiovascular eventPredictive valuePlaque AtheroscleroticCardiovascular DiseasesPredictive value of testsCerebrovascular DisorderCardiologyFemaleCardiology and Cardiovascular MedicineHumanAdultmedicine.medical_specialtyPrognosicerebrovascular eventFollow-Up StudiePredictive Value of TestsCarotid Intima-Media ThickneInternal medicinemedicineHumansAsymptomatic DiseasesAgedAsymptomatic DiseaseCarotid Artery Diseasebusiness.industryVascular diseaseRisk FactorBiomarkermedicine.diseaseEndothelin 1Settore MED/11 - Malattie Dell'Apparato CardiovascolareProspective StudieCerebrovascular DisordersHigh plasmaAsymptomatic DiseasesbusinessBiomarkersFollow-Up Studiesdescription
BACKGROUND AND PURPOSE: Clinical and experimental evidence suggests that endothelin-1 (Et-1) plays a role in cardiac and vascular disease. In the present study, we investigated the prognostic significance of Et-1 for cerebrovascular and cardiovascular outcome, in a 20-year follow-up. METHODS: We studied 82 originally healthy individuals, referred to our Unit of Cardiovascular Prevention, to evaluate the presence of asymptomatic carotid lesions. We subdivided these individuals into two groups, according to the plasma values of Et-1 (respectively ≤ or >2.7 pg/ml). Traditional cardiovascular risk factors were investigated, and by carotid ultrasound examination, we distinguished between normal individuals and those with intima-media thickening or asymptomatic carotid plaque. RESULTS: Major cardiac and cerebral events (all-cause death, myocardial infarction, revascularization procedures, fatal and nonfatal stroke) were registered in 41 individuals and significantly more in those with high vs. low Et-1 levels (95 vs. 5%; P < 0.0001). Furthermore, by logistic multivariate regression analysis, we found that among all evaluated baseline clinical and laboratory variables, hypertension [odds ratio (OR): 20.4 (3.3-127), P = 0.001], high Et-1 concentrations [OR: 1.4 (1.0-1.8), P = 0.02] and the presence of intima-media thickness or asymptomatic carotid plaque [OR: 3.7 (1.14-12.1), P = 0.02] were independent predictors of future events. Finally, integrating technical and laboratory data, high levels of Et-1 have defined a high risk of major cardiac and cerebral event and stroke at follow-up, which increased in relation to the progression of carotid atherosclerosis (P < 0.05). CONCLUSION: Et-1 plasmatic levels significantly influence the cardiovascular and cerebrovascular risk profile, beyond traditional cardiovascular risk factors and preclinical carotid atherosclerosis.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2014-07-08 |