Endothelial dysfunction as predictor of angina recurrence after successful percutaneous coronary intervention using second generation drug eluting stents

Francesco Burzotta, Carlo Trani, Gaetano Antonio Lanza, Filippo Crea, Rocco Antonio Montone, Giampaolo Niccoli, Federico Vergni, Vincenzo Vetrugno, Michele Russo, Francesco Fracassi, Italo Porto, Antonio Maria Leone, Domenico D'Amario, Cristina Aurigemma, Fabio Mangiacapra

Risultato della ricerca: Contributo in rivistaArticolo in rivista

6 Citazioni (Scopus)

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.
Lingua originaleEnglish
pagine (da-a)1360-1370
Numero di pagine11
RivistaEuropean Journal of Preventive Cardiology
Volume25
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • Cardiology and Cardiovascular Medicine
  • Endothelial dysfunction
  • Epidemiology
  • PCI
  • recurrent angina

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