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Endothelial dysfunction as predictor of angina recurrence after successful percutaneous coronary intervention using second generation drug eluting stents.
- Source :
-
European journal of preventive cardiology [Eur J Prev Cardiol] 2018 Sep; Vol. 25 (13), pp. 1360-1370. Date of Electronic Publication: 2018 May 22. - Publication Year :
- 2018
-
Abstract
- Background The role of endothelial dysfunction in predicting angina recurrence after percutaneous coronary intervention is unknown. Design We assessed the role of peripheral endothelial dysfunction measured by reactive-hyperaemia peripheral-artery tonometry (RH-PAT) in predicting recurrence of angina after percutaneous coronary intervention. Methods We enrolled consecutive patients undergoing percutaneous coronary intervention with second-generation drug-eluting stents. RH-PAT was measured at discharge. The endpoint was repeated coronary angiography for angina recurrence and/or evidence of myocardial ischaemia at follow-up. Patients with in-stent restenosis and/or significant de novo stenosis were defined as having angina with obstructed coronary arteries (AOCA); all other patients as having angina with non-obstructed coronary arteries (ANOCA). Results Among 100 patients (mean age 66.7 ± 10.4 years, 80 (80.0%) male, median follow-up 16 (3-20) months), AOCA occurred in 14 patients (14%), ANOCA in nine patients (9%). Repeated coronary angiography occurred more frequently among patients in the lower RH-PAT index tertile compared with middle and upper tertiles (14 (41.2%) vs. 6 (18.2%) vs. 3 (9.1%), p = 0.006, respectively). ANOCA was more frequent in the lower RH-PAT index tertile compared with middle and upper tertiles. In the multivariate regression analysis, the RH-PAT index only predicted angina recurrence. The receiver operating characteristic curve of the RH-PAT index to predict the angina recurrence demonstrated an area under the curve of 0.79 (95% confidence interval: 0.69-0.89; p < 0.001), with a cut-off value of 1.705, having sensitivity 74% and specificity 70%. Conclusions Non-invasive assessment of peripheral endothelial dysfunction using RH-PAT might help in the prediction of recurrent angina after percutaneous coronary intervention, thus identifying patients who may need more intense pharmacological treatment and risk factor control.
- Subjects :
- Aged
Angina Pectoris epidemiology
Angina Pectoris surgery
Female
Follow-Up Studies
Humans
Incidence
Italy epidemiology
Male
Prognosis
Prosthesis Design
ROC Curve
Recurrence
Retrospective Studies
Risk Factors
Survival Rate trends
Angina Pectoris physiopathology
Drug-Eluting Stents
Endothelium, Vascular physiopathology
Percutaneous Coronary Intervention
Vasodilation physiology
Subjects
Details
- Language :
- English
- ISSN :
- 2047-4881
- Volume :
- 25
- Issue :
- 13
- Database :
- MEDLINE
- Journal :
- European journal of preventive cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 29785885
- Full Text :
- https://doi.org/10.1177/2047487318777435