Assessment of the relation between initial culprit vessel patency in acute ST-elevation myocardial infarction and endothelial function

Jasveen Kandhai-Ragunath, Harald T. Jorstad, Bjorn de Wagenaar, Frits H.A.F. de Man, Martin G. Stoel, Jan van Es, Cees J.A. Doelman, Carine J.M. Doggen, Ron J.G. Peters, Clemens von Birgelen

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Abstract

Aims: To assess whether better endothelial function increases the likelihood of patients with acute ST-elevation myocardial infarction (STEMI) having initially patent culprit vessels. Clinical data on the relation between endothelial function and culprit vessel patency in STEMI patients are scarce.

Methods and results: In this prospective cohort study in 71 patients with STEMI, endothelial function was non-invasively assessed by use of the reactive hyperaemia peripheral artery tonometry (RH-PAT) method at four to six weeks after the primary percutaneous coronary intervention (PPCI). The RH-PAT index measured on average 1.90±0.58. In patients with patent culprit vessels before PPCI (n=33, 46.5%), endothelial function was significantly better than in patients with occluded vessels (n=38, 53.5%) (RH-PAT index 2.08±0.34 vs. 1.75±0.35; p<0.007). Compared to patients with normal endothelial function, the patients with severe endothelial dysfunction had a fivefold higher risk of presenting with an occluded culprit vessel (OR 5.1, 95% CI: 1.8-14.2). Logistic regression analysis revealed that this relation between endothelial function and vessel patency became even stronger after adjustment for potential confounders (adjusted OR 7.1, 95% CI: 2.1-23.6).

Conclusions: In this series of patients with acute STEMI, better endothelial function was independently associated with a higher likelihood of presenting with an initially patent culprit vessel. - See more at: http://www.pcronline.com/eurointervention/78th_issue/137/#sthash.qG5DbUl1.dpuf

Original languageEnglish
Article number137
Pages (from-to)784-791
JournalEuroIntervention
Volume10
Issue number7
DOIs
Publication statusPublished - 2014

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Hyperemia
Manometry
Arteries
Percutaneous Coronary Intervention
Likelihood Functions
ST Elevation Myocardial Infarction
Cohort Studies
Logistic Models
Regression Analysis
Prospective Studies

Keywords

  • IR-100503
  • METIS-307072
  • Myocardial infarction
  • Coronary artery disease
  • ST-elevation myocardial infarction (STEMI)
  • Endothelial function
  • Culprit vessel patency
  • Reactive hyperaemia peripheral artery tonometry

Cite this

Kandhai-Ragunath, Jasveen ; Jorstad, Harald T. ; de Wagenaar, Bjorn ; de Man, Frits H.A.F. ; Stoel, Martin G. ; van Es, Jan ; Doelman, Cees J.A. ; Doggen, Carine J.M. ; Peters, Ron J.G. ; von Birgelen, Clemens. / Assessment of the relation between initial culprit vessel patency in acute ST-elevation myocardial infarction and endothelial function. In: EuroIntervention. 2014 ; Vol. 10, No. 7. pp. 784-791.
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title = "Assessment of the relation between initial culprit vessel patency in acute ST-elevation myocardial infarction and endothelial function",
abstract = "Aims: To assess whether better endothelial function increases the likelihood of patients with acute ST-elevation myocardial infarction (STEMI) having initially patent culprit vessels. Clinical data on the relation between endothelial function and culprit vessel patency in STEMI patients are scarce.Methods and results: In this prospective cohort study in 71 patients with STEMI, endothelial function was non-invasively assessed by use of the reactive hyperaemia peripheral artery tonometry (RH-PAT) method at four to six weeks after the primary percutaneous coronary intervention (PPCI). The RH-PAT index measured on average 1.90±0.58. In patients with patent culprit vessels before PPCI (n=33, 46.5{\%}), endothelial function was significantly better than in patients with occluded vessels (n=38, 53.5{\%}) (RH-PAT index 2.08±0.34 vs. 1.75±0.35; p<0.007). Compared to patients with normal endothelial function, the patients with severe endothelial dysfunction had a fivefold higher risk of presenting with an occluded culprit vessel (OR 5.1, 95{\%} CI: 1.8-14.2). Logistic regression analysis revealed that this relation between endothelial function and vessel patency became even stronger after adjustment for potential confounders (adjusted OR 7.1, 95{\%} CI: 2.1-23.6).Conclusions: In this series of patients with acute STEMI, better endothelial function was independently associated with a higher likelihood of presenting with an initially patent culprit vessel. - See more at: http://www.pcronline.com/eurointervention/78th_issue/137/#sthash.qG5DbUl1.dpuf",
keywords = "IR-100503, METIS-307072, Myocardial infarction, Coronary artery disease, ST-elevation myocardial infarction (STEMI), Endothelial function, Culprit vessel patency, Reactive hyperaemia peripheral artery tonometry",
author = "Jasveen Kandhai-Ragunath and Jorstad, {Harald T.} and {de Wagenaar}, Bjorn and {de Man}, {Frits H.A.F.} and Stoel, {Martin G.} and {van Es}, Jan and Doelman, {Cees J.A.} and Doggen, {Carine J.M.} and Peters, {Ron J.G.} and {von Birgelen}, Clemens",
year = "2014",
doi = "10.4244/EIJV10I7A137",
language = "English",
volume = "10",
pages = "784--791",
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Kandhai-Ragunath, J, Jorstad, HT, de Wagenaar, B, de Man, FHAF, Stoel, MG, van Es, J, Doelman, CJA, Doggen, CJM, Peters, RJG & von Birgelen, C 2014, 'Assessment of the relation between initial culprit vessel patency in acute ST-elevation myocardial infarction and endothelial function' EuroIntervention, vol. 10, no. 7, 137, pp. 784-791. https://doi.org/10.4244/EIJV10I7A137

Assessment of the relation between initial culprit vessel patency in acute ST-elevation myocardial infarction and endothelial function. / Kandhai-Ragunath, Jasveen; Jorstad, Harald T.; de Wagenaar, Bjorn; de Man, Frits H.A.F.; Stoel, Martin G.; van Es, Jan; Doelman, Cees J.A.; Doggen, Carine J.M.; Peters, Ron J.G.; von Birgelen, Clemens.

In: EuroIntervention, Vol. 10, No. 7, 137, 2014, p. 784-791.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Assessment of the relation between initial culprit vessel patency in acute ST-elevation myocardial infarction and endothelial function

AU - Kandhai-Ragunath, Jasveen

AU - Jorstad, Harald T.

AU - de Wagenaar, Bjorn

AU - de Man, Frits H.A.F.

AU - Stoel, Martin G.

AU - van Es, Jan

AU - Doelman, Cees J.A.

AU - Doggen, Carine J.M.

AU - Peters, Ron J.G.

AU - von Birgelen, Clemens

PY - 2014

Y1 - 2014

N2 - Aims: To assess whether better endothelial function increases the likelihood of patients with acute ST-elevation myocardial infarction (STEMI) having initially patent culprit vessels. Clinical data on the relation between endothelial function and culprit vessel patency in STEMI patients are scarce.Methods and results: In this prospective cohort study in 71 patients with STEMI, endothelial function was non-invasively assessed by use of the reactive hyperaemia peripheral artery tonometry (RH-PAT) method at four to six weeks after the primary percutaneous coronary intervention (PPCI). The RH-PAT index measured on average 1.90±0.58. In patients with patent culprit vessels before PPCI (n=33, 46.5%), endothelial function was significantly better than in patients with occluded vessels (n=38, 53.5%) (RH-PAT index 2.08±0.34 vs. 1.75±0.35; p<0.007). Compared to patients with normal endothelial function, the patients with severe endothelial dysfunction had a fivefold higher risk of presenting with an occluded culprit vessel (OR 5.1, 95% CI: 1.8-14.2). Logistic regression analysis revealed that this relation between endothelial function and vessel patency became even stronger after adjustment for potential confounders (adjusted OR 7.1, 95% CI: 2.1-23.6).Conclusions: In this series of patients with acute STEMI, better endothelial function was independently associated with a higher likelihood of presenting with an initially patent culprit vessel. - See more at: http://www.pcronline.com/eurointervention/78th_issue/137/#sthash.qG5DbUl1.dpuf

AB - Aims: To assess whether better endothelial function increases the likelihood of patients with acute ST-elevation myocardial infarction (STEMI) having initially patent culprit vessels. Clinical data on the relation between endothelial function and culprit vessel patency in STEMI patients are scarce.Methods and results: In this prospective cohort study in 71 patients with STEMI, endothelial function was non-invasively assessed by use of the reactive hyperaemia peripheral artery tonometry (RH-PAT) method at four to six weeks after the primary percutaneous coronary intervention (PPCI). The RH-PAT index measured on average 1.90±0.58. In patients with patent culprit vessels before PPCI (n=33, 46.5%), endothelial function was significantly better than in patients with occluded vessels (n=38, 53.5%) (RH-PAT index 2.08±0.34 vs. 1.75±0.35; p<0.007). Compared to patients with normal endothelial function, the patients with severe endothelial dysfunction had a fivefold higher risk of presenting with an occluded culprit vessel (OR 5.1, 95% CI: 1.8-14.2). Logistic regression analysis revealed that this relation between endothelial function and vessel patency became even stronger after adjustment for potential confounders (adjusted OR 7.1, 95% CI: 2.1-23.6).Conclusions: In this series of patients with acute STEMI, better endothelial function was independently associated with a higher likelihood of presenting with an initially patent culprit vessel. - See more at: http://www.pcronline.com/eurointervention/78th_issue/137/#sthash.qG5DbUl1.dpuf

KW - IR-100503

KW - METIS-307072

KW - Myocardial infarction

KW - Coronary artery disease

KW - ST-elevation myocardial infarction (STEMI)

KW - Endothelial function

KW - Culprit vessel patency

KW - Reactive hyperaemia peripheral artery tonometry

U2 - 10.4244/EIJV10I7A137

DO - 10.4244/EIJV10I7A137

M3 - Article

VL - 10

SP - 784

EP - 791

JO - EuroIntervention

JF - EuroIntervention

SN - 1774-024X

IS - 7

M1 - 137

ER -