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Endothelin-1 and acute myocardial infarction: A no-reflow mediator after successful percutaneous myocardial revascularization

European Heart Journal, ISSN: 0195-668X, Vol: 27, Issue: 15, Page: 1793-1798
2006
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Article Description

Aims: No-reflow after a primary percutaneous coronary intervention (PCI) is associated with a high incidence of left ventricular (LV) failure and a poor prognosis. Endothelin-1 (ET-1) is a potent endothelium-derived vasoconstrictor peptide and an important modulator of neutrophil function. Elevated systemic ET-1 levels have recently been reported to predict a poor prognosis in patients with acute myocardial infarction (AMI) treated by primary PCI. We aimed to investigate the relationship between systemic ET-1 plasma levels and no-reflow in a group of AMI patients treated by primary PCI. Methods and results: A group of 51 patients (age 59±9.9 years, 44 males) with a first AMI, undergoing successful primary or rescue PCI, were included in the study. Angiographic no-reflow was defined as coronary TIMI flow grade ≤2 or TIMI flow 3 with a final myocardial blush grade ≤2. Blood samples were obtained from all patients on admission for ET-1 levels measurement. No reflow was observed in 31 patients (61%). Variables associated with no-reflow at univariate analysis included culprit lesion of the left anterior coronary descending artery (LAD) (67 vs. 29%, P=0.006) and ET-1 plasma levels (3.95±0.7 vs. 3.3±0.8 pg/mL, P=0.004). At multivariable logistic regression analysis, ET-1 was the only significant predictor of no-reflow (P=0.03) together with LAD as the culprit vessel (P=0.04). Conclusion: ET-1 plasma levels predict angiographic no-reflow after successful primary or rescue PCI. These findings suggest that ET-1 antagonists might be beneficial in the management of no-reflow. © The European Society of Cardiology 2006. All rights reserved.

Bibliographic Details

Niccoli, Giampaolo; Lanza, Gaetano Antonio; Shaw, Sidney; Romagnoli, Enrico; Gioia, Domenico; Burzotta, Francesco; Trani, Carlo; Mazzari, Mario A; Mongiardo, Rocco; De Vita, Maria; Rebuzzi, Antonio G; Lüscher, Thomas F; Crea, Filippo

Oxford University Press (OUP)

Medicine

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