Correlation between plasma endothelin-1 and coronary collateral circulation formation

Zhang Tao; Zhou Xintao

doi:10.3969/j.issn.1674-4055.2017.11.22

Abstract：Objective To discuss the relationship between plasma endothelin-1 (ET-1) and formation of coronary collateral circulation (CCC) in patients with chronic total occlusion (CTO) of coronary artery. Methods The clinical materials of CTO patients (n=158, male 102 and female 56) from the Department of Cardiology of the General Hospital of Guoyao Dongfeng Company were retrospectively analyzed from Jan. 2014 to Dec. 2016. The situation of collateral vessels was graded according to Rentrop grading criteria in all patients. Rentrop grades 0-I was regarded as poor CCC formation (group 1, n=73), and Rentrop grades Ⅱ-Ⅲ, as good CCC formation (group 2, n=85). The clinical data, including high-sensitivity C-reactive protein (hs-CRP), white blood cell count (WBC) and left ventricular ejection fraction (LVEF) were collected, and level of plasma ET-1 was detected by using radioimmunoassay (RIA). Results The percentages of patients with diabetes and multi-vessel lesions, and WBC and hs-CRR were higher in group 1 than those in group 2 (all P<0.05). LVEF and percentage of patients with right coronary occlusion were higher in group 2 than those in group 1 (all P<0.05). The level of plasma ET-1 was (81.2 ±10.1) pg/mL in group 1 and (67.5±9.4) pg/mL in group 2 (P<0.01). The level of plasma ET-1 was higher in patients with Rentrop grades 0 or I than that in patients with Rentrop grades Ⅱ or Ⅲ (all P<0.05). The results of multi-factor Logistic regression analysis showed that increased level of plasma ET-1 was a risk factor of good CCC formation (OR=2.24, 95%CI: 1.35~3.72, P<0.01), and other influence factors on CCC formation included diabetes, hs-CRP and right coronary occlusion. In prediction of poor CCC formation by ET-1, the AUC of ROC was 0.80 (95%CI: 0.72~0.88, P<0.01), the optimum cut-off point was 75.3 pg/mL, sensitivity was 69.0% and specificity was 79.0%. Conclusion The level of plasma ET-1 is closely correlated to CCC formation, and higher ET-1 level is an independent risk factor of good CCC formation in CTO patients.