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Combination of Flow-Mediated Vasodilation and Nitroglycerine-Induced Vasodilation Is More Effective for Prediction of Cardiovascular Events.
- Source :
-
Hypertension (Dallas, Tex. : 1979) [Hypertension] 2016 May; Vol. 67 (5), pp. 1045-52. Date of Electronic Publication: 2016 Mar 14. - Publication Year :
- 2016
-
Abstract
- Unlabelled: Measurement of nitroglycerine-induced vasodilation has been performed to differentiate endothelium-dependent vasodilation from endothelium-independent vasodilation as a control test for flow-mediated vasodilation (FMD). Recently, nitroglycerine-induced vasodilation per se has been reported to be a useful marker of the grade of atherosclerosis. The present study aimed to evaluate the prognostic value of FMD combined with nitroglycerine-induced vasodilation for future cardiovascular events. We measured FMD and nitroglycerine-induced vasodilation in 402 subjects, including patients with cardiovascular diseases. During a median follow-up period of 32.3 months, 38 first major cardiovascular events (death from cardiovascular causes, acute myocardial infarction, stroke, and coronary revascularization) occurred. Receiver-operator characteristic curve analysis revealed that FMD alone and nitroglycerine-induced vasodilation alone can predict cardiovascular events with areas under the curve of 0.671 (cutoff 3.3%) and 0.692 (cutoff 11.6%), respectively. FMD combined with nitroglycerine-induced vasodilation predicts cardiovascular events with an area under the curve of 0.701. After adjustment for age, sex, and cardiovascular risk factors, above cutoff FMD (≥3.3%) and below cutoff nitroglycerine-induced vasodilation (<11.6%; hazard ratio, 5.55; 95% confidence interval, 1.61-25.46;P=0.006) and below cutoff FMD (<3.3%) and below cutoff nitroglycerine-induced vasodilation (<11.6%; hazard ratio, 7.20; 95% confidence interval, 2.37-31.36;P<0.001) remained strong independent indicator of cardiovascular events. These findings suggest that the combination of FMD and nitroglycerine-induced vasodilation measurements can more accurately predict cardiovascular events compared with FMD alone.<br />Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: UMIN000001167.<br /> (© 2016 American Heart Association, Inc.)
- Subjects :
- Adult
Aged
Atherosclerosis drug therapy
Blood Flow Velocity drug effects
Brachial Artery physiology
Cohort Studies
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
ROC Curve
Retrospective Studies
Risk Factors
Atherosclerosis diagnosis
Brachial Artery drug effects
Cardiovascular Diseases physiopathology
Endothelium, Vascular drug effects
Nitroglycerin administration & dosage
Vasodilation drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4563
- Volume :
- 67
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Hypertension (Dallas, Tex. : 1979)
- Publication Type :
- Academic Journal
- Accession number :
- 26975705
- Full Text :
- https://doi.org/10.1161/HYPERTENSIONAHA.115.06839