The level of endothelin-1 in prognostiсation of adverse cardiac remodeling after ST-elevation myocardial infarction

Abstract

Most patients have a good survival after myocardial infarction due to modern methods of treatment. However, certain disadvantages are still present today: the incidence of heart failure is increasing dramatically. Supervision those patients needs grate expenses, especially during the war. That is why it is continuing the search of the predictors important in the prognostication of heart failure.
 Objective — to determine the value of endothelin‑1 (ET‑1) on prediction of adverse cardiac remodeling in ST‑elevation myocardial infarction (STEMI) patients successfully treated with primary percutaneous coronary intervention.
 Materials and methods. We prospectively enrolled 162 individuals with STEMI who were successfully treated with primary percutaneous coronary intervention. The biomarkers (ET‑1, cardiac troponins) and echocardiographic parameters were evaluated at the baseline.
 Results. The study group was divided into two: with high and low ET‑1 level, based on median 2.75 pg/ml, which was the cutoff point with the highest combination of sensitivity and specificity calculated using receiver operating characteristic (ROC). ROC analysis demonstrated endothelin prognostic potential for left ventricle remodeling. The cut‑off was less than 2.97 pg/ml (sensitivity — 83%, specificity — 62%, area under curve (AUC) — 0.70, 95% confident interval 0.516—0.847, p=0.03). Endothelin biomarker was evaluated as a possible predictor of left ventricular remodeling using logistic regression analysis. Endothelin‑1 showed properties of predicting adverse cardiac remodeling (95% confident interval 0.696—0.956, AUC — 0.861, χ2=9.03, p=0.43).
 Conclusions. Determination of ET‑1 level will allow to use adequate medical management in adverse cardiac remodeling prognosis in STEMI patients to prevent heart failure development.