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Association of coronary microvascular dysfunction with restenosis of left anterior descending coronary artery disease treated by percutaneous intervention.
- Source :
-
International journal of cardiology [Int J Cardiol] 2016 Sep 15; Vol. 219, pp. 322-5. Date of Electronic Publication: 2016 Jun 14. - Publication Year :
- 2016
-
Abstract
- Background: Several patients with successful percutaneous coronary interventions (PCIs) show evidence of coronary microvascular dysfunction (CMVD), which can be responsible for persistent positivity of electrocardiographic exercise stress test (EST). In this study, we assessed whether post-PCI CMVD may predict clinical outcome in patients undergoing successful elective PCI of an isolated stenosis of the left anterior descending (LAD) coronary artery.<br />Methods: We studied 29 patients (age 64±6, 23 M) with stable coronary artery disease and isolated stenosis (>75%) of the LAD coronary artery who underwent successful PCI with stent implantation. Coronary blood flow (CBF) velocity response to adenosine and to cold-pressor test (CPT) was assessed in the LAD coronary artery by transthoracic Doppler echocardiography 24h and 3months after PCI. The primary end-point was a combination of death, admission for acute coronary syndromes (ACS) or target vessel revascularization (TVR).<br />Results: No death or ACS occurred during 36months of follow-up, but TVR was performed in 5 patients (17.2%). CBF response to CPT at 3months after PCI was 1.31±0.2 vs. 1.71±0.4 in patients with or without TVR, respectively (p=0.03), whereas CBF response to adenosine at 3months in these two groups was 1.70±0.3 vs. 2.05±0.4 (p=0.059).<br />Conclusions: Our data suggest that, in patients with successful PCI of LAD coronary artery stenosis, lower CBF response to the endothelium-dependent vasodilator stimulus CPT is associated with long-term recurrence of restenosis.<br /> (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Aged
Coronary Artery Disease diagnostic imaging
Coronary Circulation physiology
Coronary Restenosis diagnostic imaging
Coronary Vessels surgery
Echocardiography trends
Exercise Test methods
Female
Follow-Up Studies
Humans
Male
Microvessels diagnostic imaging
Middle Aged
Percutaneous Coronary Intervention adverse effects
Treatment Outcome
Coronary Artery Disease physiopathology
Coronary Artery Disease surgery
Coronary Restenosis physiopathology
Coronary Vessels physiopathology
Microvessels physiopathology
Percutaneous Coronary Intervention trends
Subjects
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 219
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 27344133
- Full Text :
- https://doi.org/10.1016/j.ijcard.2016.06.031