Abstract 2540: Coronary Endothelial Function in Relation to Risk Factors and Framingham Score in Symptomatic Patients with Early Coronary Atherosclerosis
We explored the relation between the traditional Framingham risk score (FRS) and presence of coronary risk factors (RF) to coronary endothelial function in pts with early coronary atherosclerosis. We evaluated 1063 consecutive pts [age: 50±12 yrs, 676 (64%) females] without significant stenosis (<30%) on coronary angiography, who underwent invasive assessment of coronary endothelial function. Coronary blood flow (CBF) and epicardial coronary artery diameter (CAD) in response to the endothelium-dependent vasodilator acetylcholine were evaluated, as well as the microvascular (endothelium-independent) coronary flow reserve (CFR) in response to adenosine. CBF, CFR, microcirculatory function (CBF & CFR combined) and CAD were analyzed in relation to the FRS and presence of RF. Higher FRS was a univariate predictor of lower CBF (p=0.05), lower CFR (p<0.001), and lower microcirculatory function (p<0.001). Multivariate analysis showed no association between RF and epicardial endothelial function (CAD), but identified advancing age (p=0.002), female sex (p<0.001), and hypercholesterolemia (p=0.037) as independent predictors of lower microcirculatory function (figure⇓). Higher FRS was not an independent predictor of reduced coronary endothelial function. In pts with early coronary atherosclerosis, the presence of RF were associated with reduced coronary microcirculatory function but not with epicardial vasoreactivity. Higher FRS was not an independent predictor of reduced coronary endothelial function. Novel methods of risk assessment should be considered in early coronary atherosclerosis, especially in women.