The Role of Endothelin-1, Kidney Function and Diabetes in Patients With Coronary Artery Disease Underwent Percutaneous Coronary Intervention

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2025-07-21 DOI:10.1111/1753-0407.70127

Zixiang Ye, Enmin Xie, Yuan Du, Wenjia Zhang, Kefei Dou

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Abstract

Objective

This study aimed to explore the association between plasma big endothelin-1 (ET-1) and major adverse cardiovascular events (MACE) in CAD patients who underwent PCI with a focus on the influence of kidney function and diabetes status in secondary prevention.

Methods

A prospective cohort of CAD patients underwent PCI and patients with impaired kidney function and diabetes were initially screened and categorized separately, subdivided based on ET-1 levels. The primary outcome was MACE, including all-cause mortality, nonfatal myocardial infarction, unplanned revascularization, and stroke. Statistical analyses included Cox regression, competing risks analysis (competing for non-cardiovascular death), and restricted cubic spline to assess the relationships between ET-1 and MACE.

Results

This study included 1344 CAD patients with impaired kidney function and 10,577 CAD patients with DM. During a median follow-up of 3 years, 20% of renal dysfunction patients and 12.9% of DM patients experienced MACE. In CAD patients with renal dysfunction, elevated ET-1 levels were associated with increased MACE risk (adjusted HR 1.333, 95% CI 1.169–1.519, p < 0.001), with those in the highest group and DM showing a 2.134-fold (95% CI, 1.334–3.413, p < 0.001) increased MACE risk. In CAD patients with DM, patients with eGFR ≤ 60 mL/min/1.73 m² and elevated ET-1 levels had a 2.297-fold (95% CI 1.822–2.895) increased risk of MACE.

Conclusion

ET-1 offered important prognostic value for CAD patients who underwent PCI, with especially bad prognoses observed in those with elevated ET-1 levels, renal dysfunction, and DM.

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内皮素-1、肾功能和糖尿病在冠心病患者经皮冠状动脉介入治疗中的作用

目的探讨冠心病患者行PCI后血浆大内皮素-1 （ET-1）与主要心血管不良事件（MACE）的关系，重点探讨二级预防中肾功能和糖尿病状况的影响。方法对行PCI的CAD患者和肾功能受损、糖尿病患者进行前瞻性队列筛选，分别进行分类，并根据ET-1水平进行细分。主要终点为MACE，包括全因死亡率、非致死性心肌梗死、计划外血运重建术和卒中。统计分析包括Cox回归、竞争风险分析（竞争非心血管死亡）和限制性三次样条来评估ET-1与MACE之间的关系。结果本研究纳入1344例冠心病合并肾功能受损患者和10577例冠心病合并糖尿病患者。在中位3年的随访期间，20%的肾功能不全患者和12.9%的糖尿病患者经历了MACE。在伴有肾功能不全的CAD患者中，ET-1水平升高与MACE风险增加相关（校正HR 1.333, 95% CI 1.169-1.519, p < 0.001），其中最高组和DM组的MACE风险增加2.134倍（95% CI, 1.334-3.413, p < 0.001）。在CAD合并DM患者中，eGFR≤60 mL/min/1.73 m2且ET-1水平升高的患者发生MACE的风险增加2.297倍（95% CI 1.822-2.895）。结论ET-1对行PCI的CAD患者有重要的预后价值，其中ET-1水平升高、肾功能不全、DM患者预后较差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.