Endothelial dysfunction is involved in the process of acute myocardial infarction (AMI), that is, the endothelial cell–specific molecule 1 (ESM-1; endocan) is a novel endothelial dysfunction marker. However, the relationship between patients with AMI and serum ESM-1 levels is not very clear. Patients with AMI (n = 216) and a control group (n = 60) without AMI were included in the study. High-sensitivity C-reactive protein (hsCRP) was measured, and the severity of AMI was assessed by a modified Gensini stenosis scoring system. Serum ESM-1 levels were significantly higher in the AMI group (P < .05). High-sensitivity C-reactive protein levels were also significantly higher in the AMI group (P < .05). In patients with AMI, serum ESM-1 levels were not significantly correlated with hsCRP levels. There was no significant correlation between serum ESM-1 level and Gensini score. Our findings suggest that serum ESM-1 levels may be a novel biomarker of endothelial dysfunction in patients with AMI.

Background/Aims: Acute ST-segment elevation of myocardial infarction (STEMI) is the most severe type of acute coronary syndrome (ACS). Particular attention has been focused on studying the pathogenesis of STEMI, and how to prevent thrombosis, reduce inflammatory reaction, stabilize plaques and improve vascular endothelial functions to preserve the survived myocardium. This study aimed to compare the anti-inflammatory endothelium-protective effects, clinical prognosis, and relevant bleeding risks of ticagrelor versus clopidogrel in patients with STEMI who underwent urgent percutaneous coronary intervention (PCI) and provide certain experimental evidence and a theoretical basis for the selection of safe and effective drugs and their proper dosage, thereby further guiding clinical medication. Methods: We sequentially enrolled 193 patients (104 males and 89 females) admitted to hospital due to acute STEMI. These patients underwent urgent PCI between December 2013 and May 2015 and met the inclusion criteria. They were assigned (1: 1) into two groups according to different treatments, 97 patients in the ticagrelor group (treatment group), and 96 patients in the clopidogrel group (control group). Levels of hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), and endothelial cell-specific molecule 1 (ESM-1) taken at admission and 24 h, 4 days, and 7 days after administration, as well as the correlation between the levels of IL-6, hs-CRP, and ESM-1, were determined in the two groups. At the same time, the effects of treatment with ticagrelor and clopidogrel on the efficacy endpoint events (ischemic and safety) were explored. Results: No statistically significant difference was found in the levels of hs-CRP, IL-6, or ESM-1 at admission between the two groups (P> 0.05); Their levels were significantly elevated 24 h after administration, with statistical differences between two groups (P< 0.05). Furthermore, a downward trend with statistically significant differences was found on Day 4 and Day 7 (P< 0.05); ESM-1 levels increased along with increases of hs-CRP and IL-6 levels, indicating ESM-1 was positively correlated with hs-CRP (r=0.523, P< 0.001) and IL-6 (r=0.431, P< 0.001); and the occurrence rates of ischemic endpoint events at 30 days were lower in the treatment group than in the control group. The occurrence of safety endpoint events was higher than in the control group; however, no statistically significant difference was found (P> 0.05). Conclusions: Compared with clopidogrel, ticagrelor appears to rapidly reduce the prevalence of inflammatory reactions and stabilize the functions of vascular endothelium to improve the stability of atherosclerotic plaque and decrease the occurrence rate of thrombosis as well as ischemic outcome events without any obvious increase in the risk of bleeding in patients with acute STEMI receiving urgent PCI. This renders it a potential drug for clinical practice. At the same time, measurement of ESM-1, a new biological marker for vascular endothelial function disorder, could possibly become a simple, effective, and practical new method for clinical evaluation of risk stratification of patients with acute STEMI at admission.

Aims: Identification and intervention of left ventricular hypertrophy (LVH) in essential hypertension (EH) are important for the prevention of adverse cardiovascular events. However, effective methods for diagnosing LVH are still lacking. This study aimed to explore the relationship between soluble ST2 (sST2) and LVH in EH patients to identify a potential specific biomarker for hypertensive LVH. Methods and results: This study included 97 EH patients. Based on the criteria for LVH, participants were divided into the LVH group (n = 52) and the non-LVH group (n = 45). The level of serum sST2 was detected by enzyme-linked immunosorbent assay. Pearson correlation analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were used to investigate the potential of sST2 as a biomarker of LVH in EH patients. Compared with the non-LVH group, the sST2 level was elevated in EH patients with LVH (P < 0.001). Pearson correlation analysis indicated that the sST2 level was positively correlated with the left ventricular mass index in EH patients (r = 0.454, P < 0.001). Logistic regression analysis showed that the odds ratio (OR) value of LVH was 2.990, suggesting that sST2 is an independent risk factor for LVH in EH patients [OR = 2.990, 95% confidence interval (CI), 1.650–5.419; P < 0.001]. The area under the ROC curve was 0.767 (95% CI, 0.669–0.866; P < 0.001), with a sensitivity of 0.808 and specificity of 0.689, indicating the possibility of considering sST2 as a biomarker for diagnosing LVH. Conclusions: Up-regulation of sST2 is strongly related to LVH in EH patients, is an independent risk factor for hypertensive LVH, and can be used as a biomarker for the diagnosis of LVH.

In total, 97 acute ST-segment elevation myocardial infarction (STEMI) patients who received an emergency percutaneous coronary intervention (PCI) were enrolled and divided into a ticagrelor group and a clopidogrel group. Thrombolysis in myocardial infarction (TIMI) blood flow and the corrected TIMI frame count (CTFC) were used to assess the blood perfusion of culprit vessels. Thromboelastography (TEG) was used to evaluate the antiplatelet effect of drugs. The results showed that the incidence of TIMI grade III blood flow in the ticagrelor group was significantly higher than that in the clopidogrel group. The CTFC in the anterior descending, circumflex, and right coronary arteries was statistically significantly lower in the ticagrelor group as compared with that in the clopidogrel group. At 2 h and 7 d postdrug treatment, the adenosine diphosphate-induced platelet inhibition rate (ADP%) in the ticagrelor group increased significantly as compared with that in the clopidogrel group, and the platelet aggregation rate of the ADP pathway (MAADP) decreased significantly in the ticagrelor group versus that in the clopidogrel group. In conclusion, ticagrelor significantly improved TIMI blood flow and had a better antiplatelet effect than clopidogrel in STEMI patients undergoing an emergency PCI.

The biomarkers galectin‐3 (Gal‐3) and endothelial cell‐specific molecule 1 (ESM‐1) reflect endothelial function and inflammation. As a consequence, they play an important role in both the diagnosis and characterization of ST‐segment elevation myocardial infarction (STEMI). However, no prior study has explored the association between ESM‐1 and Gal‐3 in STEMI patients. This study is aimed at determining the ESM‐1 and Gal‐3 levels in the serum of STEMI patients and then exploring the correlation between the levels of these two biomarkers and their clinical significance in STEMI patients. The participants were divided into two groups: the ST group comprised 35 hospitalized STEMI patients while the control group comprised 24 people with normal coronary arteries. In all the patients, venous blood was taken from the middle of the antecubital fossa. The serum ESM‐1 and Gal‐3 concentrations were determined using an enzyme‐linked immunosorbent assay. The results revealed that the ESM‐1 and Gal‐3 levels in the STEMI patients were 1.6 and 2.8 times higher, respectively, when compared with the controls (P < 0.001). Moreover, the ESM‐1 and Gal‐3 levels exhibited a positive linear correlation (r = 0.758, P < 0.001) in the acute STEMI patients. In conclusion, the ESM‐1 and Gal‐3 levels were found to be significantly elevated and correlated in the STEMI patients. Thus, combining these two biomarkers of endothelial dysfunction and inflammation might be useful for the diagnosis and assessment of STEMI.