Severe endothelial dysfunction was independently associated with a higher risk of presenting with an occluded culprit vessel in STEMI patients (adjusted OR 7.1; 95% CI 2.1-23.6).
Cohort (n=71)
Is better endothelial function associated with a higher likelihood of initially patent culprit vessels in patients with acute STEMI?
Better endothelial function is independently associated with a higher likelihood of an initially patent culprit vessel in patients presenting with acute STEMI.
Odds Ratio: 7.1 (95% CI 2.1–23.6)
p-value: p=<0.007
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.
Kandhai-Ragunath et al. (Sat,) conducted a cohort in Acute ST-elevation myocardial infarction (STEMI) (n=71). Severe endothelial dysfunction vs. Normal endothelial function was evaluated on Occluded culprit vessel before primary percutaneous coronary intervention (adjusted OR 7.1, 95% CI 2.1-23.6, p=<0.007). Severe endothelial dysfunction was independently associated with a higher risk of presenting with an occluded culprit vessel in STEMI patients (adjusted OR 7.1; 95% CI 2.1-23.6).
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