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Title: Prognostic value of endothelial function noninvasive assessment in patients with acute coronary syndrome nonobstructive coronary angiography

Abstract:

BACKGROUND: Among patients referred to cathlab with the diagnosis of ACS exists a subgroup presenting with symptoms of myocardial ischemia and no critical lesions in coronary angiography. OBJECTIVES: We investigated the value of reactive hyperemia peripheral arterial tonometry (PAT) as a noninvasive tool for identification and stratification of clinical outcome in patients with ACS and no significant coronary lesions (non-obstructive CAD), as well as its changes in response to high and low dose statin therapy. METHODS: Between September 2009 and October 2011 fifty patients with diagnosis of acute coronary syndrome (STEMI, NSTEMI) with coronary angiography considered as normal or near-normal were included. Patients were randomized to two groups: receiving atorvastatin 20 mg OD (group A) or atorvastatin 80 mg OD (group B). PAT examinations were performed at screening, 1 month and 3 months follow–up visits. During 12 months clinical follow-up incidence of major adverse cardiac events was assessed. RESULTS: During the follow-up there was a trend for better outcome (MACE rate) in group B (12%) than in group A (28%, p=0,09). Average RHI was significantly higher after one and three months in group B than in group A. On multivariate analysis: atorvastatin 80 mg administration, smoking, ST-segment elevation on admission ECG were independent positive predictors of restoration of correct endothelial function. CONCLUSIONS: The long term outcome of these patients is not as benign as it is commonly perceived. Endothelial dysfunction can be easily detected in reactive hyperemia peripheral arterial tonometry and safely reversed with administration of high dose atorvastatin.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree discipline:

choroby układu krążenia

Degree grantor:

Uniwersytet Jagielloński. Collegium Medicum Wydział Lekarski.

Promoter:

Jacek S. Dubiel

Date issued:

2012

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:3575

Call number:

ZB-118665

ControlNumberVIRTUA:

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Language:

pol

Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

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Last modified:

Jun 27, 2019

In our library since:

Jul 17, 2013

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Number of object content views in PDF format

5

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/3575

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ZB-118665 Jun 27, 2019
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