Abstract 732: Prevalence of Positive Cold Pressor Test in a Population Without Coronary Artery Disease. Its Significance After 66 Months Follow up
Endothelial dysfunction(ED) is the first known change, that occurs in coronary artery disease (CAD). There are different ways to study ED, one of which is cold pressor test(CPT) perfusion with single positron emision tomography (SPECT).
Aim: to determine the prevalence of positive CPT, in 668 consecutive individuals, without demostrated CAD, and analyze the incidence of cardiovascular events during a follow up of 66 months.
Material and methods: we included 668 consecutive patients (p), tested in a Nuclear Cardiology Center, with a normal execise myocardial perfusion SPECT, none of these p had a history of coronary revascularization nor myocardial infarction. After a time window of 2 to 5 days, a CPT was done. A positive CPT was defined as a new perfusion defect compared with the baseline SPECT, and a negative one as no perfusion defects. The mean follow up was 33+/− 11 months, in 94,6% of the p. The events analyzed were mortality, myocardial infarction and coronary revascularization. Mean age was 59 +/− 10 years, with a 56% of male prevalence. The risk factors were: Diabetes 11.9 %, family history of CAD 53.5%, Dyslipidemia 72.4%, Hypertensión 64.4%, Obesity 25.5% (IMC>=30) and current smokers 20,9%.
Results: 37% of the p had a positive CPT. The p excluded were 4.2% due to intolerance to the CPT and 3.1% due to vasovagal reactions. During the 66 month follow up, the event free rate was of 97% in the negative CPT and 91,5% in the positive CPT (p value < 0,0069).
Conclusion : In our population without demostrated CAD the prevalence of positive CPT was 37%. Positive CPT could identify patients at risk of future cardiovascular events.