Association of plasma endothelin-1 levels with revascularization strategies and short-term clinical outcomes: Role of diabetes

• Published in: Heliyon 2024-09, Vol.10 (18), p.e37777, Article e37777
• Main Authors: Mayyas, Fadia, Ibrahim, Khalid, Ibdah, Rasheed, Al-Kasasbeh, Abdullah, Ababneh, Muhannad J., Ababneh, Ala’Eldin A., Jarrah, Mohammad I., Rawashdeh, Sukaina
• Format: Article
• Language: English
• Subjects: Cardiovascular event; Cerebrovascular event; Coronary artery bypass surgery; Coronary artery disease; Diabetes mellitus; Endothelin-1; Percutaneous coronary intervention; Revascularization
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2024.e37777

Mortality rate due to coronary artery disease (CAD) is elevated among diabetes mellitus (DM) compared to non-DM patients. Endothelin 1 (ET-1), a potent vasoconstrictor, is implicated in the pathophysiology of both CAD and DM. The impact of ET-1 on the short-term clinical outcomes following revascularization by percutaneous coronary intervention (PCI) and coronary artery bypass surgery (CABG) remains unclear. We investigated the impact of ET-1 on clinical outcomes and revascularization strategies in CAD patients, exploring the role of DM on modifying these relationships. In a prospective observational study, patients presenting to cardiac catheterization lab for CAD evaluation at a Jordanian hospital were enrolled and stratified by status of CAD and DM. Plasma levels of ET-1 were measured before catheterization. Short-term clinical outcomes and prognosis were compared. Among 815 enrolled patients (603 CAD and 212 controls), DM prevalence was higher among CAD patients than non-CAD. Plasma ET-1 levels were measured in 490 random patients and were associated with CAD and the need for revascularization. Multivariate analysis independently revealed higher plasma ET-1 levels in DM patients requiring revascularization. Short-term follow-up for 366 patients (median of 4 months) showed that 132 developed one cerebro/cardiovascular event, predominantly among DM patients. Baseline ET-1 was not associated with higher risk of the first event. Notably, revascularization by PCI was associated with lower event risk in DM patients. Our study indicates that plasma ET-1 levels are associated with the need for revascularization in DM patients, with those undergoing PCI having a lower risk of initial cerebro/cardiovascular events.