מתוך medicontext.co.il
LONDON (Reuters Health) – Increased plasma endothelin levels appear to be predictive of rapid coronary artery disease progression in patients with chronic stable angina pectoris, UK researchers report in the September issue of the European Heart Journal.
Dr. E. G. Zouridakis and colleagues from St. George's Hospital Medical School in London assessed progression of coronary stenosis in 92 consecutive patients with angina. They underwent angiography at baseline and again after an average of 5.5 months, just before undergoing angioplasty.
In 29 patients rapid coronary artery disease was seen on the second angiogram, with 12 patients having a reduction in the diameter in at least one stenosis of 10% or more and 10 patients with a 30% or more reduction. Five patients developed a new stenosis and two patients had lesions that became completely occluded, the researchers report.
Among the patients with rapid coronary artery disease progression, plasma endothelin levels were significantly higher compared with patients whose disease did not progress (p = 0.001), Dr. Zouridakis's group found. Levels of endothelin above 4.26 pg/mL were associated with a sixfold increased risk of rapid stenosis progression.
"Our results thus suggest that endothelin may play a pathogenic role in rapid coronary artery disease progression," Dr. Zouridakis and colleagues conclude.
"The knowledge of the basic mechanism of coronary atherosclerosis progression and of the processes responsible for the transformation of a silent atherosclerotic coronary plaque into an active explosive lesion is a major challenge for modern coronary research," Dr. A. Gaspardone from Universitא di Roma Tor Vergata, Italy, comments in a journal editorial.
"Endothelin has all the attributes necessary to play a crucial role in both processes, and the pilot findings by Zouridakis et al. represent a useful observation to direct our future research," Dr. Gaspardone writes.
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