LAUSR

In ST segment elevation acute myocardial infarction (STEMI), the endothelin (ET) system imbalance, reflected by circulating ET-1:ET-3 ratio has not been investigated. This study primary objective was to measure the circulating ET-1:ET-3 ratio and correlated it with the risk stratification for 1-year mortality of STEMI, based on TIMI score. On admission TIMI risk score and at discharge dynamic TIMI risk score were calculated in 68 consecutive subjects with STEMI. Subjects with high TIMI risk score associated with higher mean ET-1 level and ET-1:ET-3 ratio. The ET-1:ET-3 ratio more accurately predicted the high TIMI risk score than ET-1 level. Subjects with high dynamic TIMI risk score associated with higher mean ET-1 level and ET-1:ET-3 ratio. The ET-1:ET-3 ratio more accurately predicted the high dynamic TIMI risk score than ET-1 level. From multivariable analysis, the ET-1:ET-3 ratio did not independently associated with high on admission TIMI risk score but independently predicted high at discharge dynamic TIMI risk score (OR 9.186, p value 0.018). In conclusion, combining the ET-1 and ET-3 levels into the ET-1:ET-3 ratio provided a prognostic value by independently predicting the increased risk to 1-year mortality as indicated by at discharge dynamic TIMI risk score in patients with STEMI.