Endothelial function predicts 1-year adverse clinical outcome in patients hospitalized in the emergency department chest pain unit
Endothelial function predicts 1-year adverse clinical outcome in patients hospitalized in the emergency department chest pain unit
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DOI：
10.1016/j.ijcard.2017.04.101
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发表时间：
2017-08-01
影响因子：
3.5
通讯作者：
Lerman, Amir
中科院分区：
文献类型：
--
作者：
Shechter, Michael;Matetzky, Shlomi;Lerman, Amir
背景：内皮功能是心血管风险的标志物。因此，内皮功能异常可能与急诊科胸痛病房（CPU）患者的1年不良结局相关。在内皮功能测试后，在300名胸痛且无冠状动脉疾病（CAD）病史的连续受试者中使用EndoPAT 2000进行CPU，例患者接受冠状动脉计算机断层血管造影（CCTA）或单光子发射计算机断层扫描。平均10年Fragrance风险评分（FRS）为6.6 +/-5.9%，反应性充血指数（RHI）中位数（作为内皮功能指标）为2.08，平均值为2.0 +/- 0.4。在1年的随访中，20名发生主要不良心血管终点（MACE）（包括全因死亡率、非致死性心肌梗死、因心力衰竭或心绞痛住院、卒中、冠状动脉旁路移植术和经皮冠状动脉介入治疗）的患者（6.6%）的10年FRS较高（10.5 +/- 8.2% vs 6.3 +/- 5.7%; p < 0.001），较低的基线RHI（1.43 +/- 0.41 vs 2.10 +/- 0.44; p < 0.001）和更大程度的冠状动脉粥样硬化病变（70% vs 3.9%，p < 0.001）。RHI为中位数。多因素分析表明，RHI
Background: Endothelial function is a marker for cardiovascular risk. Thus, abnormal endothelial function may be associated with adverse 1-year outcome in patients presenting to the emergency department chest pain unit (CPU).Methods: Following endothelial function testing, using EndoPAT 2000 in 300 consecutive subjects with chest pain and no history of coronary artery disease (CAD) presenting to CPU, patients underwent coronary computerized tomographic angiography (CCTA) or single-photon emission computed tomography according to availability.Results: Mean 10-year Framingham risk score (FRS) was 6.6 +/- 5.9%, median reactive hyperemia index (RHI) as a measure of endothelial function 2.08 and mean was 2.0 +/- 0.4. During a 1-year follow-up, the 20 (6.6%) patients who developed major adverse cardiovascular end-points (MACE), including all-cause mortality, non-fatal myocardial infarction, hospitalization for heart failure or angina pectoris, stroke, coronary artery bypass grafting and percutaneous coronary interventions, had higher 10-year FRS (10.5 +/- 8.2% vs 6.3 +/- 5.7%; p < 0.001), lower baseline RHI (1.43 +/- 0.41 vs 2.10 +/- 0.44; p < 0.001) and a greater extent of coronary atherosclerosis lesions (70% vs 3.9%, p < 0.001) in the CPU CCTA, compared to those without MACE. RHI the median. Multivariate analysis demonstrated that RHI