Long-Term Prognostic Role of Flow-Mediated Dilatation of the Brachial Artery After Acute Coronary Syndromes Without ST Elevation
| Autor: | Paraskevi Voidonikola, Athanassios D. Protogerou, Theodore G. Papaioannou, G. Vamvakou, Emmanouil N. Karatzis, Kalliopi Karatzi, Ignatios Ikonomidis, John Lekakis, Ioanna Andreadou, Christos Papamichael |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Brachial Artery medicine.medical_treatment Coronary Disease Revascularization Malondialdehyde Internal medicine medicine.artery Myocardial Revascularization medicine Humans Ultrasonics Myocardial infarction Brachial artery Ejection fraction Troponin T business.industry Unstable angina ST elevation Stroke Volume Syndrome Middle Aged Prognosis medicine.disease Vasodilation Oxidative Stress Acute Disease Circulatory system cardiovascular system Cardiology Endothelium Vascular Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 98:1424-1428 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2006.06.043 |
| Popis: | Coronary endothelial vasodilator dysfunction is associated with increased cardiac events; the close relation between coronary vasomotor dysfunction and brachial artery vasoreactivity has been previously described. This study assessed the prognostic value of noninvasively assessed brachial artery vasoreactivity in survivors of acute coronary syndromes without ST-segment elevation. We examined 98 men (63.1 +/- 10.8 years) who were referred to our hospital for acute coronary syndromes without ST-segment elevation. Brachial artery endothelium-dependent flow-mediated dilation (FMD) and endothelium-independent nitrate-mediated dilation were examined in all patients using high-resolution echocardiographic Doppler ultrasound within 24 hours of admission. Plasma malondialdehyde, a marker of oxidative stress, and left ventricular ejection fraction were also assessed. Twenty-seven patients underwent coronary revascularization. Patients were followed for 24.8 +/- 5.9 months. Cardiovascular death, myocardial infarction, stroke, and unstable angina were designated as cardiovascular events (CEs). Twenty CEs were recorded. Kaplan-Meyer analysis showed that patients with FMD1.9% (tertile 1 of FMD values) were more likely to have CEs than those with FMD1.9% (log rank 5.29, p = 0.021). Multivariate Cox regression analysis showed that FMD1.9% predicted CEs with an adjusted hazard ratio of 3.035 (95% confidence interval 1.148 to 8.023, p = 0.025) after adjustment for age, risk factors, troponin T, ejection fraction, revascularization procedures, number of diseased vessels, and medication. In conclusion, endothelium-dependent dilation of the brachial artery is a strong independent predictor of adverse outcome in survivors of acute coronary syndromes without ST-segment elevation. |
| Databáze: | OpenAIRE |
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