Author + information
- Received September 11, 1995
- Revision received February 23, 1996
- Accepted March 4, 1996
- Published online July 1, 1996.
- Oscar A. Salomone, MD,
- Perry M. Elliott, MRCP,
- Ramón Calviño, MD,
- David Holt, MRCPath and
- Juan Carlos Kaski, MD, FESC, FACC∗
- ↵∗Address for correspondence: Dr. Juan Carlos Kaski, Coronary Artery Disease Research Group, Department of Cardiological Sciences, St. George's Hospital Medical School, Crammer Terrace, London, SW17 ORF England, United Kingdom.
Objectives. The present study tested the hypothesis that plasma immunoreactive endothelin concentration correlates with the severity and extent of coronary atherosclerosis.
Background. Plasma endothelin-1 concentration is increased in patients with unstable coronary syndromes and advanced atherosclerosis. This finding, together with other clinicopathologic observations, suggests that endothelins may participate in the atherogenic process. However, the relation between plasma immunoreactive endothelin and coronary artery disease in patients with stable angina pectoris remains controversal.
Methods. Ninety consecutive patients undergoing coronary angiography for the investigation of exertional chest pain and 49 normal control subjects were prospectively studied. Eleven patients had normal coronary angiographic findings (group I), 65 had coronary artery stenoses (group II), and 14 had coronary artery disease plus symptoms indicating atheroma in other vascular territories (group III). Computerized angiography was used to determine the extent, severity and morphology of coronary stenoses. Plasma immunoreactive endothelin was measured by radioimmunoassay.
Results. Mean (± SD) plasma endothelin concentration (pg/ml) was significantly higher in patients than in control subjects (7.29 ± 4.07 vs. 3.48 ± 1.29, p < 0.0001). Endothelin levels were higher in patients of group III than in those of groups II and I (9.43 ± 5.48, 7.20 ± 3.72 and 4.94 ± 2.89, respectively, p = 0.02). In patients of group II, plasma endothelin correlated with the maximal degree of stenosis in each patient (r = 0.25, p = 0.04) and with the number of stenoses with ≥70% diameter narrowing (r = 0.36, p = 0.002). The highest plasma endothelin levels were found in patients with total occlusions (8.65 ± 3.78 vs. 6.46 ± 3.51, p = 0.02).
Conclusions. Plasma immunoreactive endothelin concentration is increased in patients with chronic stable angiuya. The highest levels occur in patients with severe stenoses and total coronary occlusion.
☆ Dr. Salomone is supported by a grant from the “Consejo de Investigaciones de la Provincia de Cordoba”. Cordoba, Argentina, Dr. Elliott is supported by a grant from the British Heart Foundation London.
- Received September 11, 1995.
- Revision received February 23, 1996.
- Accepted March 4, 1996.