Predictive value of endothelial function by noninvasive peripheral arterial tonometry for coronary artery disease. Issue 3 (May 2015)

• Record Type: Journal Article
• Authors: Matsuzawa, Yasushi; Li, Jing; Aoki, Tatsuo; Guddeti, Raviteja R.; Kwon, Taek-Geun; Cilluffo, Rebecca; Widmer, Robert Jay; Gulati, Rajiv; Lennon, Ryan J.; Lerman, Lilach O.; Lerman, Amir
• Is Part Of: Coronary artery disease. Volume 26:Issue 3(2015:May)
• Publication Date: 2015-05
• Subjects: Coronary heart disease -- Periodicals; Coronary Disease -- Indexes; Coronary Disease -- Periodicals; 616.123005
• DOI: 10.1097/MCA.0000000000000208
• Languages: English
• ISSNs: 0954-6928

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background</title> <p>Endothelial dysfunction is a key step in the initiation and progression of atherosclerosis and subsequent cardiovascular complications. We examined whether peripheral endothelial function, as assessed by fingertip reactive hyperemia-peripheral arterial tonometry (RH-PAT), can provide additional clinical value to traditional risk factors for cardiovascular diseases in predicting coronary artery disease (CAD).</p> </sec> <sec> <title>Methods</title> <p>We included 118 stable patients who were referred for coronary angiography for chest pain evaluation or due to abnormal stress test results. A natural logarithmic value of the RH-PAT index (Ln_RHI) was obtained before cardiac catheterization by an independent operator. Significant CAD was defined as luminal stenosis of at least 70% (≥50% at left main) and/or fractional flow reserve of up to 0.80 in one or more major coronary arteries or their major branches.</p> </sec> <sec> <title>Results</title> <p>Levels of Ln_RHI were significantly lower in patients with CAD (<italic>n</italic>=60) compared with patients without CAD (<italic>n</italic>=58; 0.69±0.29 vs. 0.88±0.27, <italic>P</italic><0.001). Ln_RHI was significantly associated with CAD independent from traditional risk factors (odds ratio for a 0.1 decrease in Ln_RHI=1.25, 95% confidence interval: 1.04–1.52, <italic>P</italic>=0.01). The net reclassification index was improved when Ln_RHI was added to traditional risk factors (0.62, 95% confidence interval: 0.27–0.97, <italic>P</italic>=0.001).</p> </sec> <sec> <title>Conclusion</title> <p>Peripheral endothelial function, as assessed by RH-PAT, improved risk stratification when added to traditional risk factors. RH-PAT is potentially useful for identifying patients at high risk for CAD.</p> </sec> </abstract>