Elevated endothelin-1 level is a risk factor for nonocclusive mesenteric ischemia
Open accessAbstract
Objective Nonocclusive mesenteric ischemia may occur after cardiac surgery, commonly in conjunction with the use of cardiopulmonary bypass. Some evidence suggests that endothelin-1 serum levels are increased in patients with mesenteric ischemia, but the association of endothelin-1 and nonocclusive mesenteric ischemia has not been studied. The objective was to investigate whether elevated levels of endothelin-1 could be found in patients exhibiting nonocclusive mesenteric ischemia.Methods In an observational cohort study, nonocclusive mesenteric ischemia developed in 78 of 865 patients undergoing elective cardiac surgery. Control patients were identified from the cohort through 1:1 propensity score matching. Preoperative and postoperative endothelin-1 serum levels were determined by means of enzyme-linked immunosorbent assay. Odds ratios (with 95% confidence interval) were calculated by logistic regression analyses to determine the risk of endothelin-1 for the development of nonocclusive mesenteric ischemia.Results Patients with nonocclusive mesenteric ischemia had higher preoperative (11.3 vs 9.3 pg/mL; P = .001) and postoperative (15.7 vs 11.1 pg/mL, P < .001) levels of endothelin-1 than the controls. The probability of developing nonocclusive mesenteric ischemia increased with each picogram/milliliter endothelin-1 level preoperatively (odds ratio, 1.29; 95% confidence interval, 1.12-1.49) and each picogram/milliliter postoperatively (odds ratio, 2.04; 95% confidence interval, 1.54-2.72). Receiver operating characteristic analyses showed that elevated endothelin-1 serum levels had a high accuracy to predict nonocclusive mesenteric ischemia (optimal cutoff value of 14.5 pg/mL, area under the curve of 0.77, sensitivity 51%, and specificity 94%).Conclusions Endothelin-1 seems to predispose patients undergoing cardiac surgery to develop nonocclusive mesenteric ischemia. In addition, it may be a useful marker to identify patients at risk for nonocclusive mesenteric ischemia after cardiac surgery.
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Serum endothelin-1 had sensitivity 51% and specificity 94% in a single study.
“Serum endothelin-1 (51 and 94%) [92].”
From Diagnostic accuracy of biomarkers to detect acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis (2023) · cites this paper as [92]
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References 29 · Cited by 33
- Authors
- Groesdonk, H. V., Raffel, M., Speer, T., Bomberg, H., Schmied, W., Klingele, M., & Schäfers, H.-J.
- Affiliations
- Universitätsklinikum des Saarlandes (DE)
- Corresponding author
- Schäfers, Hans-Joachim
- ORCID
- Venue
- The Journal of Thoracic and Cardiovascular Surgery
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 149
- Issue
- 5
- Pages
- 1436-1442.e2
- ISSN
- 0022-5223 (ISSN-L)
- OpenAlex
- W2020348451
- Cited by
- 33
- References
- 29
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 7 · 2023: 6 · 2022: 2 · 2021: 3 · 2019: 1 · 2018: 4 · 2017: 5 · 2016: 2 · 2015: 1
- FWCI
- 2.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Keywords
- nonocclusive mesenteric ischemia, endothelin-1, cardiac surgery, cardiopulmonary bypass, serum biomarkers, postoperative complications, risk factors
- MeSH terms
- Aged, Cardiopulmonary Bypass, Female, Cardiac Surgical Procedures, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Risk Factors, ROC Curve, Biomarkers, Up-Regulation, Chi-Square Distribution, Logistic Models, Odds Ratio, Treatment Outcome, Risk Assessment, Endothelin-1, Area Under Curve, Propensity Score, Mesenteric Ischemia
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