Predicting Severity of Coronary Artery Disease in Patients With Diabetes Using Endothelial Function Measured With Peripheral Arterial Tonometry: PROCEED Study

Angiology ◽  
2019 ◽  
Vol 70 (7) ◽  
pp. 613-620 ◽  
Author(s):  
Shreenidhi Venuraju ◽  
Anand Jeevarethinam ◽  
Vishal Shahil Mehta ◽  
Sherezade Ruano ◽  
Alain Dumo ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Reactive Hyperemia ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Artery Disease ◽  
Peripheral Arterial

Endothelial dysfunction is common in patients with type 2 diabetes mellitus (T2DM) and is associated with atherosclerotic disease. This study aimed to determine prognostic factors for endothelial dysfunction and identify relationships between reactive hyperemia index (RHI) score, clinically relevant coronary artery disease (>50% stenosis), and major adverse cardiovascular events (MACEs) in patients with T2DM. Endothelial function was assessed using peripheral arterial tonometry and correlated with patient characteristics and cardiovascular outcomes during a median follow-up of 22.8 months. Among 235 patients with a median duration of T2DM of 13 years, mean (standard deviation) RHI score was 2.00 (0.76). Serum low- and high-density lipoprotein cholesterol levels positively ( P = .004) and negatively ( P = .02) predicted RHI score, respectively. Median coronary artery calcium (CAC) score was 109 Agatston units, but no correlation between CAC and RHI scores was observed. The RHI score did not predict the number or severity of coronary plaques identified using computed tomography coronary angiography. Additionally, there was no association between RHI score and the risk of an MACE during follow-up. Overall, endothelial function was not predictive of CAC score, extent, and severity of coronary plaque or MACEs and did not demonstrate utility in cardiovascular risk stratifying patients with T2DM.

scholarly journals Predictive value of endothelial function by noninvasive peripheral arterial tonometry for coronary artery disease

2015 ◽  
Vol 26 (3) ◽  
pp. 231-238 ◽  
Author(s):  
Yasushi Matsuzawa ◽  
Jing Li ◽  
Tatsuo Aoki ◽  
Raviteja R. Guddeti ◽  
Taek-Geun Kwon ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Function ◽  
Predictive Value ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Artery Disease ◽  
Peripheral Arterial

scholarly journals Effects of Monotherapy with Clopidogrel vs. Aspirin on Vascular Function and Hemostatic Measurements in Patients with Coronary Artery Disease: The Prospective, Crossover I-LOVE-MONO Trial

2021 ◽  
Vol 10 (12) ◽  
pp. 2720
Author(s):  
Hyun-Woong Park ◽  
Min-Gyu Kang ◽  
Jong-Hwa Ahn ◽  
Jae-Seok Bae ◽  
Udaya S. Tantry ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Function ◽  
Vascular Function ◽  
Platelet Reactivity ◽  
Reactive Hyperemia ◽  
Open Label ◽  
Peripheral Arterial Tonometry ◽  
Coagulation Activity ◽  
Artery Disease

To evaluate the effect of clopidogrel vs. aspirin monotherapy on vascular function and hemostatic measurement. Background: Monotherapy with P2Y12 receptor inhibitor vs. aspirin can be a useful alterative to optimize clinical efficacy and safety in high-risk patients with coronary artery disease (CAD). Methods: We performed a randomized, open-label, two-period crossover study in stented patients receiving at least 6-month of dual antiplatelet therapy (DAPT). Thirty CAD patients with moderate-to-high ischemic risk were randomly assigned to receive either 75 mg of clopidogrel or 100 mg of aspirin daily for 4 weeks, and were crossed over to the other strategy for 4 weeks. Vascular function was evaluated with reactive hyperemia-peripheral arterial tonometry (RH-PAT) and brachial-ankle pulse wave velocity (baPWV). Hemostatic profiles were measured with VerifyNow and thromboelastography (TEG). The primary endpoint was the reactive hyperemia index (RHI) during clopidogrel or aspirin monotherapy. Results: Clopidogrel vs. aspirin monotherapy was associated with better endothelial function (RHI: 2.11 ± 0.77% vs. 1.87 ± 0.72%, p = 0.045), lower platelet reactivity (130 ± 64 vs. 214 ± 50 P2Y12 reaction unit [PRU], p < 0.001) and prolonged reaction time (TEG R: 5.5 ± 1.2 vs. 5.1 ± 1.1 min, p = 0.037). In multivariate analysis, normal endothelial function (RHI ≥ 2.1) was significantly associated with clot kinetics (TEG angle ≤ 68 degree) and ‘PRU ≤ 132’. ‘PRU ≤ 132’ was achieved in 46.2% vs. 3.8% during clopidogrel administration vs. aspirin monotherapy (odds ratio 21.4, 95% confidence interval 2.7 to 170.1, p < 0.001). Conclusions: In CAD patients, clopidogrel vs. aspirin monotherapy was associated with better endothelial function, greater platelet inhibition and lower coagulation activity, suggesting pleiotropic effects of clopidogrel on endothelial function and hemostatic profiles.

scholarly journals Peripheral arterial tonometry during hyperemia is blunted in patients with coronary artery disease

2003 ◽  
Vol 41 (6) ◽  
pp. 269
Author(s):  
Jeffrey T. Kuvin ◽  
Ayan R. Patel ◽  
Kathleen A. Sliney ◽  
Jacob Sheffy ◽  
Robert P. Schnall ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Artery Disease ◽  
Peripheral Arterial

scholarly journals Peripheral Arterial Tonometry for Risk Stratification in Men With Coronary Artery Disease

2010 ◽  
Vol 33 (2) ◽  
pp. 94-98 ◽  
Author(s):  
Kevin S. Heffernan ◽  
Richard H. Karas ◽  
Eshan A. Patvardhan ◽  
Haseeb Jafri ◽  
Jeffrey T. Kuvin
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Stratification ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Artery Disease ◽  
Peripheral Arterial
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