Abstract 14581: The Clinical Usefulness of Digital Peripheral Arterial Tonometry for Identifying Coronary Artery Disease (CAD) in Hypertensive Patients
Background: Using digital reactive hyperemia peripheral arterial tonometry (RH-PAT), which is a noninvasive examination of endothelial function, we evaluated whether peripheral endothelial dysfunction could associate with the presence of CAD in hypertensive patients (HT).
Methods: In 443 patients with suspected CAD including 364 HT, we assessed endothelial functions as RH index (RHI) by fingertip RH-PAT and examined the presence of CAD by coronary angiography. CAD patients were divided to single (SVD) or multiple-vessel disease (MVD), and coronary atherosclerotic lesions were classified as simple or complex according to Ambrose criteria.
Results: RHI was significantly attenuated in HT compared to non-HT. In HT, RHI was significantly lower in CAD patients (n=306) than non-CAD (n=58) (p<0.01). In ROC analysis, RHI was a significant determinant for the presence of CAD (p<0.01). Moreover, RHI of CAD with MVD (n=220) were significantly lower than those with SVD (n=86) (p<0.001). Furthermore, RHI of CAD with coronary complex plaques (n=190) were significantly lower than those with simplex plaques (n=116) (p<0.001). By multivariate backward logistic regression analysis among various risk factors, RHI independently associated with the presence of CAD, MVD and coronary complex plaques.
Conclusion: RHI significantly decreased in HT and significantly correlated with the presence of CAD, particularly with MVD and complex coronary lesions. Identifying the high-risk HT by RH-PAT may provide clinical benefits for risk stratification.
- © 2013 by American Heart Association, Inc.