Prognostic Value of Endothelin-1 Level in Diabetic Patients with Coronary Artery Disease

摘要

Objective: The aim of this work is to study the prognostic value of the plasma level of the new marker, endothelin-1 (ET-1), in diabetic patients with coronary artery disease. Background: Endothelin 1 (ET-1) has been demonstrated to play a role in endothelial dysfunction and inflammation, both of which are actively involved in the pathophysiology of the onset and progression of coronary artery disease (CAD). Diabetes mellitus increases the risk of CAD and has unfavorable effects on the vascular endothelium, hence the importance of assessing this plasma marker and its relation to the severity of CAD in diabetic patients. Patients & method: This is a cross sectional study in which data was collected from January 2019 to December 2019 and was carried out on patients selected from catheterization laboratory, faculty of medicine, Minoufia university hospital, Egypt. A total of seventy patients, 35 diabetics (groupI, GI) and 35 non-diabetics (groupII, GII), with coronary artery lesions of not less than 50% in at least one main coronary artery plus twenty patients with normal coronaries as a control group (groupIII, GIII) were enrolled. The severity of coronary artery lesions were assessed by GINSINI score (GS) and the relationship between ET-1 level and GS was evaluated. Results: The ET-1 levels were significantly higher in GI with higher GS values of 34.29+ 11.7 points and SYNTAX scores of 18.4+11.17 points, than in GII with lower GS values of 23.23+8.14 points and SYNTAX of scores 12.06+12.11 points (ET-1 was 187.93+146.61 ng/L in GI versus 76.30+91.83ng/L in GII, P value=0.001). ET-1 levels were significantly higher in GI than in GIII (187.93+146.61ng/L versus 26.16+7.32 ng/L, P value=0.001). ET-1 levels were significantly higher in GII than in GIII (76.30+91.83 ng/L versus 26.16+7.32 ng/L, P value=0.001). Conclusion: There is a positive correlation between DM and both ET-1 levels and the severity of coronary artery lesions, P value 0.001.