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

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

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