Abstract | BACKGROUND: METHODS: Using high-resolution ultrasound, we assessed endothelial function by using the brachial artery flow-mediated dilation (FMD) method in 135 patients with coronary artery disease before elective coronary stenting. Patients were prospectively followed up for an average of 12 months after PCI. RESULTS: Thirty patients had an event during follow-up including cardiac death (four patients), myocardial infarction (nine patients), unstable angina/ non-ST elevation myocardial infarction (15 patients), and stroke (two patients) and in- stent restenosis was determined in 16 of these patients. Endothelium-dependent FMD was significantly lower in patients who had an event compared with those without an event (4.7+/-1.9 vs. 6.0+/-2.0%, P=0.007), whereas endothelium-independent vasodilation to nitroglycerin was similar in both groups. FMD was the only predictor of cardiovascular events (P=0.03). Impaired endothelial function was associated with a significantly higher incidence of cardiovascular events and in- stent restenosis by Kaplan-Meier analysis. When a cutoff point of 7.5% was used, flow-mediated dilation had a sensitivity of 93%, specificity of 37%, and negative predictive value of 95% for cardiovascular events. CONCLUSION: Impaired brachial artery FMD is associated with long-term cardiovascular events and in- stent restenosis in patients undergoing PCI. Noninvasive assessment of endothelial function may serve as a surrogate marker for the estimation of future cardiovascular event risk and long-term follow-up in these patients.
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Authors | Mustafa Akcakoyun, Ramazan Kargin, Ali Cevat Tanalp, Selcuk Pala, Olcay Ozveren, Murat Akcay, Irfan Barutcu, Cevat Kirma |
Journal | Coronary artery disease
(Coron Artery Dis)
Vol. 19
Issue 5
Pg. 337-43
(Aug 2008)
ISSN: 0954-6928 [Print] England |
PMID | 18607171
(Publication Type: Journal Article)
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Chemical References |
- Vasodilator Agents
- Nitroglycerin
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Topics |
- Aged
- Angioplasty, Balloon, Coronary
(adverse effects)
- Blood Flow Velocity
- Brachial Artery
(diagnostic imaging, physiopathology)
- Cardiovascular Diseases
(physiopathology)
- Coronary Restenosis
- Coronary Stenosis
(physiopathology, therapy)
- Endothelium, Vascular
(physiopathology)
- Female
- Follow-Up Studies
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Nitroglycerin
(pharmacology)
- Predictive Value of Tests
- Prospective Studies
- Stents
(adverse effects)
- Ultrasonography
- Vasodilation
(drug effects)
- Vasodilator Agents
(pharmacology)
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