Key result
In patients with suspected coronary artery disease, low fingertip temperature rebound measured by digital thermal monitoring strongly predicted CTA-diagnosed obstructive disease (OR 11.62).
Why the study?
Does low fingertip temperature rebound measured by digital thermal monitoring correlate with the presence of obstructive coronary artery disease in symptomatic patients?
Cross-Sectional (n=129)
No
Does low fingertip temperature rebound measured by digital thermal monitoring correlate with the presence of obstructive coronary artery disease in symptomatic patients?
Odds Ratio: 11.62 (95% CI 5.1–28.7)
p-value: p=0.001
Previous studies showed strong correlations between low fingertip temperature rebound measured by digital thermal monitoring (DTM) during a 5 min arm-cuff induced reactive hyperemia and both the Framingham Risk Score (FRS), and coronary artery calcification (CAC) in asymptomatic populations. This study evaluates the correlation between DTM and coronary artery disease (CAD) measured by CT angiography (CTA) in symptomatic patients. It also investigates the correlation between CTA and a new index of neurovascular reactivity measured by DTM. 129 patients, age 63 +/- 9 years, 68% male, underwent DTM, CAC and CTA. Adjusted DTM indices in the occluded arm were calculated: temperature rebound: aTR and area under the temperature curve aTMP-AUC. DTM neurovascular reactivity (NVR) index was measured based on increased fingertip temperature in the non-occluded arm. Obstructive CAD was defined as >or=50% luminal stenosis, and normal as no stenosis and CAC = 0. Baseline fingertip temperature was not different across the groups. However, all DTM indices of vascular and neurovascular reactivity significantly decreased from normal to non-obstructive to obstructive CAD [(aTR 1.77 +/- 1.18 to 1.24 +/- 1.14 to 0.94 +/- 0.92) (P = 0.009), (aTMP-AUC: 355.6 +/- 242.4 to 277.4 +/- 182.4 to 184.4 +/- 171.2) (P = 0.001), (NVR: 161.5 +/- 147.4 to 77.6 +/- 88.2 to 48.8 +/- 63.8) (P = 0.015)]. After adjusting for risk factors, the odds ratio for obstructive CAD compared to normal in the lowest versus two upper tertiles of FRS, aTR, aTMP-AUC, and NVR were 2.41 (1.02-5.93), P = 0.05, 8.67 (2.6-9.4), P = 0.001, 11.62 (5.1-28.7), P = 0.001, and 3.58 (1.09-11.69), P = 0.01, respectively. DTM indices and FRS combined resulted in a ROC curve area of 0.88 for the prediction of obstructive CAD. In patients suspected of CAD, low fingertip temperature rebound measured by DTM significantly predicted CTA-diagnosed obstructive disease.
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Ahmadi et al. (2009) conducted a cross-sectional in Suspected coronary artery disease (n=129). Low fingertip temperature rebound (lowest tertile of aTMP-AUC) vs. Higher fingertip temperature rebound (two upper tertiles of aTMP-AUC) was evaluated on Obstructive coronary artery disease (≥50% luminal stenosis) (OR 11.62, 95% CI 5.1-28.7, p=0.001). In patients with suspected coronary artery disease, low fingertip temperature rebound measured by digital thermal monitoring strongly predicted CTA-diagnosed obstructive disease (OR 11.62).
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