Coronary artery diseaseLong-Term Prognostic Role of Flow-Mediated Dilatation of the Brachial Artery After Acute Coronary Syndromes Without ST Elevation
Section snippets
Methods
Ninety-eight men (63.15 ± 10.78 years) were studied on the second day after their admission for an acute coronary syndrome, defined as angina at rest and ST alterations, without ST-segment elevation, with or without increased troponin T. Presence of hepatic or renal insufficiency, inflammatory or malignant disease, recent (previous 3 months) myocardial infarction, or recent revascularization procedures, and an ejection fraction <40% were considered exclusion criteria. FMD and nitrate-mediated
Results
Twenty-two of 98 patients presented with high troponin levels. Patients were followed for 24.79 ± 5.92 months and 20 CEs were recorded (6 myocardial infarctions, 1 fatal; 3 deaths, 1 after infarction and 2 strokes; and 10 hospitalizations for unstable angina). Further, 27 revascularizations were performed, 18 of them (9 percutaneous coronary interventions, 9 coronary artery bypass graftings) within 1 month. Table 1 lists baseline characteristics of the study population.
Survival tables showed
Discussion
In the present study, we demonstrated for the first time that impairment of brachial artery FMD is associated with increased risk of future CEs in men surviving an acute coronary syndrome without ST elevation.
A series of previous studies has shown that endothelial dysfunction in the coronary or peripheral circulation assessed invasively or noninvasively can predict future CEs in various populations and clinical settings.23, 24 Recently, in 198 patients with an acute coronary syndrome,
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