Abstract 17290: What Factors are Associated with the Change in Endothelial Function in Patients Who Have Undergone Percutaneous Coronary Intervention?
Background: Endothelial function is one of markers predicting future cardiovascular events, even in patients with coronary artery disease (CAD). Thus, much interest is focused on the change in endothelial function in CAD patients who have undergone percutaneous coronary intervention (PCI). However, factors associated with the change in endothelial function in these patients remain unclear. Therefore, we investigated changes in the endothelial function of the brachial artery in patients who underwent PCI and clarified the factors affecting these changes.
Methods: A total of 233 CAD patients (mean age: 66 years; 185 males) who underwent successful PCI for stenotic lesions were enrolled. PCI techniques included plain old balloon angioplasty in 47 patients, stenting with a bare-metal stent in 85 patients and stenting with a drug-eluting stent (DES) in 101 patients. In each patient, the diameter of the brachial artery in response to hyperemic flow (flow-mediated dilatation: FMD) and nitroglycerin spray (nitroglycerin-induced dilation: NID) was measured using high resolution ultrasonography just before and 6-8 months after PCI. The changes in FMD and NID were defined as the differences between follow-up and baseline values. Angiographic restenosis was defined as a >50% diameter reduction at the follow-up coronary angiography. The lesion morphology before PCI was determined according to the American College of Cardiology/American Heart Association classification.
Results: In univariate analyses, body mass index (BMI, p = 0.0002), difference in NID (p = 0.0008), use of DES (p = 0.005), lesion morphology (p = 0.0314) were associated with the change in FMD. Multivariate regression analysis demonstrated that use of DES (p<0.0005) was negatively associated whereas BMI (p<0.0001) was positively associated, with the change in FMD.
Conclusions: These results suggest that use of DES has a negative impact on the change in endothelial function; however, obesity has a positive impact on the change in endothelial function in CAD patients who underwent PCI. The former may suggest the need for a careful follow-up of patients who underwent PCI with DES and the latter finding may suggest one mechanism of obesity paradox phenomenon in CAD patients who underwent PCI.
- © 2011 by American Heart Association, Inc.