ESM1 and myocardial infarction: However, higher plasma endocan levels were associated with a significantly increased risk of hard CV events, primarily in male patients, those without a family history of myocardial infarction, smokers, those not using statins or ACEi/ARB, and in patients with a baseline serum LDL-c level ≥ 70 mg/dL (Fig. 3A).