Endothelin-1 as predictor of major adverse cardiovascular events in chronic coronary syndrome patients undergoing coronary intervention [version 2; peer review: 1 approved with reservations, 1 not approved]

Background: Major adverse cardiovascular events (MACE) are predicted to be low in chronic coronary syndrome (CCS) patients who have undergone percutaneous coronary intervention (PCI). Endothelin-1 has been considered a pro inflammatory biomarker and suggested as a novel prognostic indicator in CCS. The objective of this research was to prove endothelin- 1 as predictor of MACE within 1-year evaluation in CCS patients undergoing PCI. Methods: This research was an analytic observational study with a cohort design. The participants were CCS patients who had undergone PCI. Endotelin-1 levels were checked before the patient underwent PCI. Occurrences of MACE were observed within 1 year. The comparison between normally distributed continuous data was performed with a T-test, and the Mann-Whitney test was used for not normally distributed data. A comparison between categorical data was performed with the Chi-square test . The cut-off point of endothelin-1 levels to predict MACE was analyzed by receiver operating characteristics (ROC). Results: Participants in this study were 63 patients. Six patients experienced MACE within 1 year (9.5%) and 57 patients were included in the non-MACE group (90.5%). Mann Whitney T test showed there were significance differences in endothelin-1 levels from the two groups (p=0.022). The ROC curve showed cut off point the endothelin-1 is 4.07 ng/dl with a sensitivity of 83.3%, specificity of 75.4% and accuracy of 76.2% for the occurrence of MACE. Based on the area under curve (AUC) value and the accuracy of this study, endothelin-1 was able to detect MACE within 1 year of follow-up. Conclusions: Endothelin-1 can be used as predictor of MACE within 1-year evaluation in CCS patients undergoing coronary intervention.