Key result
Radial artery intima-media thickness significantly decreased from <1 month to 4 months post-acute coronary syndrome (right: 0.35 vs 0.29; left: 0.37 vs 0.31; p<0.0001).
Why the study?
Does radial artery intima-media thickness regress over time in patients receiving secondary prevention interventions post-acute coronary syndrome?
Cohort (n=295)
Does radial artery intima-media thickness regress over time in patients receiving secondary prevention interventions post-acute coronary syndrome?
p-value: p=< 0.0001
Radial artery intima-media thickness regresses significantly at 4 months post-ACS, suggesting it may serve as a non-invasive surrogate marker to monitor vascular response to secondary prevention therapies.
Radial IMT reduction post-ACS may reflect remodeling; hypothesis-generating and should not yet change practice.
// Damilola D. Adingupu 1 , Helena U. Westergren 1, 2 , Santosh Dahgam 1 , Ann-Cathrine Jönsson-Rylander 1 , Juuso Blomster 1, 2 , Per Albertsson 4 , Elmir Omerovic 4 , Sara Svedlund 2, 3 and Li-Ming Gan 1, 2, 4 1 AstraZeneca R&D Gothenburg, Mölndal, Sweden 2 Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden 3 Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden 4 Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden Correspondence to: Li-Ming Gan, email: li-ming.gan@gu.se Keywords: atherosclerosis, cardiovascular, intima-media thickness, inflammation, ultrasound Received: December 28, 2016 Accepted: May 17, 2017 Published: June 16, 2017 ABSTRACT Background: Radial artery intima-media thickness (rIMT) measured by ultra-high-resolution ultrasound is associated with increased cardiovascular risk and predicts outcomes. We performed non-invasive high-resolution ultrasound of the radial artery to investigate vascular changes in subjects presenting with acute coronary syndrome (ACS) and who had undergone percutaneous coronary intervention (PCI). Purpose: In the present work, we aimed to follow rIMT change over time post-acute coronary syndrome as a tool to monitor potential response to intensified medical therapy. Methods: We examined 256 subjects who underwent PCI due to ACS and healthy controls (n= 39) and we measured a number of biomarkers, which are known to be associated with cardiovascular disease. Images of radial artery were acquired bilaterally in the longitudinal view using a 50 MHz transducer (Vevo 2100 VisualSonics, Inc, Toronto, Ontario, Canada). Carotid IMT (cIMT) and rIMT were measured at <1 month after index PCI followed by a repeated measurement of rIMT at 4 months from the ACS in a sub-set (n=117). Results: rIMT measured within 1 month post ACS was significantly higher than rIMT after 4 months from ACS, (p < 0.0001), mean ± SD (rIMT right 0.35 ± 0.08; rIMT left 0.37 ± 0.08) vs. (rIMT right 0.29 ± 0.08; rIMT left 0.31 ± 0.09) respectively. There was no statistically significant change in cIMT. In healthy controls there were no changes in rIMT or cIMT overtime. High levels of CX3CL1 and myeloperoxidase measured within one month post ACS are associated with increase of rIMT, r=0.38 (p< 0.0001) and r=0.41 (p< 0.0001) respectively. Conclusions: rIMT seem to decrease systemically after ACS and is accompanied with corresponding biomarker change. The cause and clinical implications of the observed decrement in rIMT after ACS need further studies.
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Adingupu et al. (2017) conducted a cohort in Acute coronary syndrome (n=295). Time post-acute coronary syndrome vs. Baseline (<1 month post-PCI) and healthy controls was evaluated on Change in radial artery intima-media thickness (rIMT) (p=< 0.0001). Radial artery intima-media thickness significantly decreased from <1 month to 4 months post-acute coronary syndrome (right: 0.35 vs 0.29; left: 0.37 vs 0.31; p<0.0001).
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