Circulating concentrations of endothelin-1 predict coronary heart disease in women but not in men: a longitudinal observational study in the Vara-Skövde Cohort.
The vasoconstricting peptide endothelin-1 has been proposed to be a marker of cardiovascular disease. Our aim was to investigate whether circulating endothelin-1 levels predict coronary heart disease (CHD) in Sweden.
In 2002-2005, 2816 adult participants (30-74 years) were randomly selected from two municipalities in south-western Sweden. Cardiovascular risk factors and endothelin-1 levels were assessed at baseline, and incident CHD was followed-up in all participants through 2011. After exclusion of 50 participants due to known CHD at baseline and 21 participants because of unsuccessful analysis of endothelin-1, 2745 participants were included in the study. In total, 72 CHD events (52 in men and 20 in women) were registered during the follow-up time.
We showed that baseline circulating endothelin-1 levels were higher in women with incident CHD than in women without CHD (3.2?pg/ml, SE: 0.36 vs 2.4?pg/ml, SE: 0.03, p?=?0.003) whereas this difference was not observed in men (2.3?pg/ml, SE: 0.16 vs 2.3?pg/ml, SE: 0.04, p?=?0.828). An age-adjusted Cox proportional regression analysis showed an enhanced risk of CHD with increasing baseline endothelin-1 levels in women (hazard ratio (HR)?=?1.51, 95?% CI?=?1.1-2.1, p?=?0.015) but not in men (HR?=?0.98, 95?% CI?=?0.8-1.2, p?=?0.854). Furthermore, the predictive value of endothelin-1 for incident CHD in women was still significant after adjustments for age, HOMA-IR, apolipoprotein (apo)B/apoA1 and smoking (HR?=?1.53, CI?=?1.1-1.2, p?=?0.024).
Circulating endothelin-1 levels may predict CHD in women.