Big ET-1 useful for risk stratification in cardiomyopathy
Big Endothelin-1 (Big ET-1) is a valuable tool for risk stratification in patients with cardiomyopathy
Big Endothelin-1 (Big ET-1) is a protein that is mainly produced by vascular endothelial and smooth muscle cells and cardiomyocytes. Big ET-1 has been identified as a risk factor for a poor prognosis in patients with atrial fibrillation or coronary artery disease. This current study revealed that plasma Big ET-1 is a valuable tool for risk stratification in patients with LVNC.
Big ET-1 useful for risk stratification in cardiomyopathy
Prognostic value of plasma big endothelin-1 in left ventricular non-compaction cardiomyopathy. Fan P et al., 2020. Heart. 2020.
Biomedica Big-ET-1 ELISA kit highlights (BI-20082H)
√ Direct measurement
√ Fully validated according to international guidelines
√ Published cut-off values
√ cited in +70 publications
CITATIONS with the Biomedica Big Endothelin-1 (Big ET-1) ELISA, cat. no. BI-20082W
Prognostic value of plasma big endothelin-1 in left ventricular non-compaction cardiomyopathy. Fan P, Zhang Y, Lu YT, Yang KQ, Lu PP, Zhang QY, Luo F, Lin YH, Zhou XL, Tian T. Heart. 2021 May;107(10):836-841. doi: 10.1136/heartjnl-2020-317059. Epub 2020 Oct 14. PMID: 33055147; PMCID: PMC8077223.
Abstract
Objective: To determine the prognostic role of big endothelin-1 (ET-1) in left ventricular non-compaction cardiomyopathy (LVNC).
Methods: We prospectively enrolled patients whose LVNC was diagnosed by cardiac MRI and who had big ET-1 data available. Primary end point was a composite of all-cause mortality, heart transplantation, sustained ventricular tachycardia/fibrillation and implanted cardioverter defibrillator discharge. Secondary end point was cardiac death or heart transplantation.
Results: Altogether, 203 patients (median age 44 years; 70.9% male) were divided into high-level (≥0.42 pmol/L) and low-level (<0.42 pmol/L) big ET-1 groups according to the median value of plasma big ET-1 levels. Ln big ET-1 was positively associated with Ln N-terminal pro-brain natriuretic peptide, left ventricular diameter, but negatively related to age and Ln left ventricular ejection fraction. Median follow-up was 1.9 years (IQR 0.9-3.1 years). Kaplan-Meier analysis showed that, compared with patients with low levels of big ET-1, those with high levels were at greater risk for meeting both primary (p<0.001) and secondary (p<0.001) end points. The C-statistic estimation of Ln big ET-1 for predicting the primary outcome was 0.755 (95% CI 0.685 to 0.824, p<0.001). After adjusting for confounding factors, Ln big ET-1 was identified as an independent predictor of the composite primary outcome (HR 1.83, 95% CI 1.27 to 2.62, p=0.001) and secondary outcome (HR 1.93, 95% CI 1.32 to 2.83, p=0.001).
Plasma Big Endothelin-1 Level Predicted 5-Year Major Adverse Cardiovascular Events in Patients With Coronary Artery Ectasia. Cai Z, Wang H, Yuan S, Yin D, Song W, Dou K.Front Cardiovasc Med. 2021 Nov 29;8:768431. doi: 10.3389/fcvm.2021.768431. PMID: 34912865; PMCID: PMC8667227.
Abstract
Background: Coronary artery ectasia (CAE) is found in about 1% of coronary angiography and is associated with poor clinical outcomes. The prognostic value of plasma big Endothelin-1 (ET-1) in CAE remains unknown. Methods: Patients with angiographically confirmed CAE from 2009 to 2015, who had big ET-1 data available were included. The primary outcome was 5-year major adverse cardiovascular events (MACE), defined as a component of cardiovascular death and non-fatal myocardial infarction (MI). Patients were divided into high or low big ET-1 groups using a cut-off value of 0.58 pmol/L, according to the receiver operating characteristic curve. Kaplan-Meier method, propensity score method, and Cox regression were used to assess the clinical outcomes in the 2 groups. Results: A total of 992 patients were included, with 260 in the high big ET-1 group and 732 in the low big ET-1 group. At 5-year follow-up, 57 MACEs were observed. Kaplan-Meier analysis and univariable Cox regression showed that patients with high big ET-1 levels were at increased risk of MACE (9.87 vs. 4.50%; HR 2.23, 95% CI 1.32-3.78, P = 0.003), cardiovascular death (4.01 vs. 1.69%; HR 2.37, 95% CI 1.02-5.48, P = 0.044), and non-fatal MI (6.09 vs. 2.84%; HR 2.17, 95% CI 1.11-4.24, P = 0.023). A higher risk of MACE in the high big ET-1 group was consistent in the propensity score matched cohort and propensity score weighted analysis. In multivariable analysis, a high plasma big ET-1 level was still an independent predictor of MACE (HR 1.82, 95% CI 1.02-3.25, P = 0.043). A combination of high plasma big ET-1 concentrate and diffuse dilation, when used to predict 5-year MACE risk, yielded a C-statistic of 0.67 (95% CI 0.59-0.74). Conclusion: Among patients with CAE, high plasma big ET-1 level was associated with increased risk of MACE, a finding that could improve risk stratification.