TY - JOUR
T1 - Endothelial dysfunction as predictor of angina recurrence after successful percutaneous coronary intervention using second generation drug eluting stents
AU - Montone, Rocco Antonio
AU - Niccoli, Giampaolo
AU - Vergni, Federico
AU - Vetrugno, Vincenzo
AU - Russo, Michele
AU - Mangiacapra, Fabio
AU - Fracassi, Francesco
AU - Porto, Italo
AU - Leone, Antonio Maria
AU - Burzotta, Francesco
AU - D'Amario, Domenico
AU - Aurigemma, Cristina
AU - Trani, Carlo
AU - Lanza, Gaetano Antonio
AU - Crea, Filippo
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
KW - Cardiology and Cardiovascular Medicine
KW - Endothelial dysfunction
KW - Epidemiology
KW - PCI
KW - recurrent angina
KW - Cardiology and Cardiovascular Medicine
KW - Endothelial dysfunction
KW - Epidemiology
KW - PCI
KW - recurrent angina
UR - http://hdl.handle.net/10807/126479
UR - http://cpr.sagepub.com/content/by/year
U2 - 10.1177/2047487318777435
DO - 10.1177/2047487318777435
M3 - Article
SN - 2047-4873
VL - 25
SP - 1360
EP - 1370
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
ER -