Association between big endothelin-1 and CHADS2/CHA2DS2-VASc scores in non-valvular atrial fibrillation

Li-Hui Zheng; Shang-Yu Liu; Feng Hu; Er-Peng Liang; Ling-Min Wu; Hong-Lei Wang; Ammar M Killu; Yan Yao

doi:10.11909/j.issn.1671-5411.2019.11.003

Association between big endothelin-1 and CHADS₂/CHA₂DS₂-VASc scores in non-valvular atrial fibrillation

J Geriatr Cardiol. 2019 Nov;16(11):812-817. doi: 10.11909/j.issn.1671-5411.2019.11.003.

Authors

Li-Hui Zheng¹, Shang-Yu Liu¹, Feng Hu¹, Er-Peng Liang¹, Ling-Min Wu¹, Hong-Lei Wang², Ammar M Killu³, Yan Yao¹

Affiliations

¹ Clinical EP Lab & Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
³ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.

PMID: 31853246
PMCID: PMC6911798
DOI: 10.11909/j.issn.1671-5411.2019.11.003

Abstract

Background: Endothelial function, as measured by big endothelin-1 (ET-1), has been demonstrated to be useful in predicting adverse long-term events in patients with cardiovascular disease. Nevertheless, there are little data about the association between big ET-1 and thromboembolism risk in atrial fibrillation (AF). We aimed to investigate the relationship between big ET-1 and CHADS₂/CHA₂DS₂-VASc scores used for evaluating thromboembolic risk in patients with non-valvular AF.

Methods: The study population consisted of 238 consecutive AF patients (67.6% with paroxysmal AF and 32.4% with persistent AF). The patients were divided into two groups (high- or low-intermediate risk group) based on CHADS₂ and CHA₂DS₂-VASc scores (score ≥ 2 or < 2, respectively). Clinical, laboratory, and echocardiographic parameters were evaluated, and the CHADS_2/CHA₂DS₂-VASc scores were compared between groups. The association between big ET-1 levels and CHADS₂/CHA₂DS₂-VASc score was assessed. Multivariate logistic regression analysis was performed to identify independent predictors of CHADS₂/CHA₂DS₂-VASc scores.

Results: The high CHADS₂/CHA₂DS₂-VASc score group had older age, higher big ET-1 levels, and enlarged left atrial diameter than the low CHADS₂/CHA₂DS₂-VASc score group (P < 0.05). Multiple logistic regression analysis revealed that big ET-1 level was an independent determinant of high CHADS₂/CHA₂DS₂-VASc scores [odds ratio (OR) = 2.545 and OR = 3.816; both P < 0.05].

Conclusions: Our study indicates that in non-valvular AF, big ET-1 was significantly correlated with CHADS₂/CHA₂DS₂-VASc scores and an independent predictor of high CHADS₂/CHA₂DS₂-VASc scores. Big ET-1 may serve as a useful marker for risk stratification in this setting.

Keywords: Atrial fibrillation; Cardiac risk factors; Prevention; Stroke.

Institute of Geriatric Cardiology.