The Association between Serum Endoglin Level and Coronary Collateral Vessel in Patients with Acute Coronary Syndromes

Abstract

Background: Previously, endoglin, also known as CD105, was shown to be related to angiogenesis. Objectives: The present study aimed to investigate the relationship between endoglin levels and development of Coronary Collateral Circulation (CCC) in patients with acute coronary syndrome. Patients and Methods: The study patients who underwent coronary angiography were divided into a poor collateral group (Group 1, N = 45) and a good collateral group (Group 2, N = 42), according to Rentrop classification. After recording the baseline characteristics, including age, Body Mass Index (BMI), systolic and diastolic blood pressures, smoking, history of hypertension, diabetes mellitus, and family history of Coronary Artery Disease (CAD), blood samples were taken for analysis of endoglin and other biochemical variables. The data were statistically analyzed using Mann-Whitney U test, independent sample t-test, chi-square test, ANOVA, Pearson's or Spearman's correlation tests, Receiver-Operating Characteristics (ROC) curve analysis, and multivariate logistic regression analysis. P values < 0.05 were considered as statistically significant. Results: Endoglin levels were significantly higher in Group 1 compared to Group 2 (13.6 +/- 3.8 vs. 10.2 +/- 2.9 ng/mL, P < 0.001). Serum endoglin levels were negatively correlated to age, C-Reactive Protein (CRP), and Low Density Lipoprotein-Cholesterol (LDL-C) levels. Moreover, ROC analysis (area under curve: 0.758; 95% CI: 0.655-0.844; P < 0.001) provided a cutoff value of <= 12.6 ng/mL for endoglin to predict good CCC with 85.7% sensitivity and 60% specificity. In multivariate logistic regression analysis, endoglin levels (OR = 0.97; 95% CI: 0.95 - 0.99; P = 0.002) and presence of total occlusion (OR = 2.51; 95% CI: 1.05 - 5.8; P = 0.036) were predictors of good CCC. Conclusions: Lower plasma endoglin levels were associated with better CCC development.