Changes And Clinic Significance Of ET-1 After PCI In Patients Of Coronary Atherosclerotic Heart Disease With Diabetes Mellitus

Objective: To investigate the serum levels of endothelin-1 (ET-1) in coronary atherosclerotic heart disease (CHD) with diabetes mellitus (DM) after percutaneous coronary interventions (PCI) and explore the role of ET-1 in the development of coronary heart disease and their relationships with clinic significance.Method: 73 consecutive patients with acute coronary syndrome who were admitted hospital for PCI and had been successfully received coronary stent were enrolled and divided into CHD with DM group (n=33) and simple CHD group (n=40). Exclusion criteria were with primary hypertension and other heart diseases such as dilated cardiomyopathy, hypertrophic obstructive cardiomyopathy and rheumatic heart disease etc, hepatic function or renal function dysfunction and with infection, malignant tumor, hematological system or immunologic system diseases. Coronary angiography was carried out on each one of the selected objects .Peripheral blood sample were taken before and thirty minutes, four hours, twenty hours after PCI. The level of ET-1 was detected by radio immunoassay. The change among the two groups and their relationships with clinical surrogate were analyzed.Result:1.The levels of fasting blood glucose (FBG), two-hour postprandial blood glucose (2hBG), triglyceride (TG), glycosylated hemoglobin A1c (HbA1c) and Gensini's score are significant higher in the CHD with DM group than simple CHD group (P<0.05). The levels of high density lipoprotein cholesterol (HDL-C) and left ventricular ejection fraction (LVEF) are significant lower (P<0.05). 2. Multi-vessel coronary artery disease incidence and degree of stenosis were significant higher in CHD with DM group than simple CHD group (P<0.05).3. The concentration of ET-1 were reach peak at 30 minutes after PCI in two groups , and then gradually decreased, it are significant higher at 4 hours after PCI (P<0.05). The concentration of ET-1 was significant higher at 24 hours after PCI compared with before in CHD with DM group (P<0.05), while down to the level before PCI in simple CHD group (P>0.05). The level of ET-1 in each time point of CHD with DM group was significant higher than simple CHD group (P<0.05).4. There existed a positive correlation between the concentration of ET-1 and FBG, 2hBG and HbA1c. There existed a negative correlation between the concentration of ET-1 and LVEF .There was no significant correlation between the concentration of ET-1 and Gensini's score.5. The rates of heart failure and total cardiovascular event were higher in the patients of CHD with DM group than the simple CHD group during hospitalization (P<0.05), the incidence of cardiogenic shock and severe arrhythmia was no significant difference (P>0.05).Conclusion: The level of ET-1 before and after PCI were significant higher in CHD with DM group than simple CHD group, it was significant higher at 24 hours after PCI than before PCI in CHD with DM group. The rates of heart failure and total cardiovascular event were higher in the patients of CHD with DM group during hospitalization.