Endocan: Endothelial Dysfunction, Inflammation, or Both?

We thank Ertem et al for their interest in our article entitled ‘‘Serum Endothelial Cell-Specific Molecule 1 (Endocan) Level in Patients With Acute Myocardial Infarction and Its Clinical Significance: A Pilot Study.’’ Endothelial cell-specific molecule 1 (ESM-1; endocan) is a novel biomarker of endothelial dysfunction. We investigated whether ESM-1 is an acute biomarker of endothelial dysfunction in patients with acute myocardial infarction. Highsensitivity C-reactive protein (hsCRP) is an inflammation marker; the number of such markers is considerable and they may respond in different ways to various triggers. Therefore, it is not impossible for hsCRP not to parallel ESM-1, although some previous studies showed that serum ESM-1 levels were positively correlated with hsCRP levels. Procalcitonin, another inflammatory marker, was an independent predictor of a high SYNTAX score (an angiographic tool used for classification complexity of coronary artery disease) in patients with acute coronary syndrome. The SYNTAX and Gensini scores are the results of many factors, not just markers of inflammation. Besides, we selected an Asian population and used different reagents, which may also cause different results.