Abstract
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.
Lingua originale | English |
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pagine (da-a) | 1793-1798 |
Numero di pagine | 6 |
Rivista | European Heart Journal |
Volume | 27 |
DOI | |
Stato di pubblicazione | Pubblicato - 2006 |
Keywords
- Angioplasty, Balloon, Coronary
- Coronary Circulation
- Endothelin-1
- Female
- Humans
- Male
- Middle Aged
- Myocardial Infarction
- Myocardial Revascularization
- Myocardial infarction
- No-reflow
- Percutaneous coronary intervention
- Prognosis
- Regression Analysis
- Reperfusion