Prognostic value of flow-mediated dilation and computed tomography angiography findings for determining cardiovascular risk in patients with subclinical atherosclerosis

Autor: Hideki Kawai, Masayoshi Sarai, Kunihiko Sugimoto, Sadako Motoyama, Yoshihiro Sato, Yasuomi Nagahara, Keiichi Miyajima, Takahiro Matsuyama, Hiroshi Takahashi, Akira Yamada, Hiroyuki Naruse, Hiroshi Toyama, Yukio Ozaki, Hideo Izawa
Rok vydání: 2023
DOI: 10.1101/2023.04.24.23289070
Popis: BackgroundFlow-mediated dilation (FMD) tests endothelial function, and computed tomography angiography (CTA) estimates the extent of coronary atherosclerosis and plaque vulnerability. This study aimed to examine the prognostic value of combining FMD and CTA in patients with no history of atherosclerotic disease.MethodsThe study retrospectively examined patients who underwent CTA and FMD within 3 months between 2012 and 2020. Patients with a history of cardio-cerebrovascular disease or significant stenoses on CTA were excluded. The study endpoint was defined as major cardiac and cerebrovascular events (MACCE): a composite of cardio-cerebrovascular death, acute coronary syndrome, fatal arrhythmia, ischaemic and haemorrhagic stroke, and late revascularisation of the coronary or carotid arteries 6 months after CTA. Finally, the patients were stratified into four groups based on the following factors: FMD ResultsDuring a mean follow-up of 4.7 years, MACCE occurred in 19 of 154 patients (mean age: 61.0±12.9 years, 89 males). FMD, PAV, and HRPs were independent predictors of MACCE after adjusting for age, sex, and hypertension. Compared with the patients with 0 points, hazard ratios of those with 1, 2, and 3 points were 2.76 (P=0.322), 9.89 (P=0.004), and 28.43 (PConclusionsAlthough FMD and CTA findings are useful for predicting cardiovascular events, their combination synergises their prognostic abilities.
Databáze: OpenAIRE