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The predictive value of big endothelin-1 on cardiovascular events in patients with coronary artery disease receiving pharmacotherapy has not been evaluated.
A total of 3283 patients with coronary artery disease were consecutively enrolled in the present study. All patients underwent coronary angiography (CAG) after admission to our hospital. Gensini score was used to evaluate the severity of coronary artery stenosis. Patients were divided into two groups according to the treatment strategy after CAG: pharmacotherapy group (n=1368) and revascularization group including percutaneous coronary intervention and coronary artery bypass grafting (n=1915). Univariate and multivariate Cox regression analysis were conducted to investigate the relationship between big endothelin-1 and MACEs. The MACEs included all-cause death, non-fatal myocardial infarction, stroke, unplanned revascularization.
The big endothelin-1 levels were significantly higher in patients with MACEs both in pharmacotherapy and revascularization group. During a median follow-up of 37.47 months, 238 events (7.25%) occurred. After adjustment for potential factors including Gensini score, multivariate Cox regression analysis indicated that big endothelin-1 was independently related to the MACEs in patients receiving pharmacotherapy (Odds ratio 1.986, 95% confidence interval: 1.212-3.253, p=0.006), but not in revascularization group (p>0.05).
Higher levels of big endothelin-1 may predict a poorer prognosis in patients with coronary artery disease receiving pharmacotherapy, but not in patients receiving revascularization.