Time course of endothelin-1 plasma level in patients with acute coronary syndromes

An elevated plasma level of endothelin-l was reported in several cardiovasc ular conditions including unstable angina pectoris and myocardial infarctio n. The present study was designed to evaluate the time course of the endoth elin-l release in unstable angina pectoris and to assess its relationship t o the development of myocardial infarction and coronary vessel occlusion. T he cohort studied included 32 patients with the clinical diagnosis of unsta ble angina pectoris who had been admitted to the coronary care unit and sub sequently underwent coronary angiography (group A). Fourteen patients with chronic stable angina pectoris referred to routine diagnostic coronary angi ography served as the control group (group B). A significant difference in the endothelin-l plasma level was found between both groups, the values bei ng 10.2 +/- 5.3 and 6.0 +/- 3.1 pg/ml (p < 0.01), respectively. There were, however, no significant differences between the following subdivisions of group A: patients with and without subsequent myocardial infarction; those with angiographically documented occlusion of at least one major branch of the coronary artery and no occlusion; and finally, those with persisting sy mptoms of angina pectoris and with favorable response to treatment. Neither was there any difference found among the subgroups differing in the time i nterval between the onset of chest pain and blood sampling. The time course of endothelin plasma concentrations showed elevated values lasting for mor e than 96 h after the index episode of prolonged chest pain, No correlation with the subsequent clinical course could be inferred. Thus, plasma endoth elin level was elevated in patients with unstable angina pectoris and myoca rdial infarction and the increase persisted for several days after the onse t of symptoms.