Document Detail

Prognostic value of flow-mediated dilatation following myocardial infarction.
MedLine Citation:
PMID:  18180054     Owner:  NLM     Status:  In-Process    
BACKGROUND: Risk stratification for subsequent cardiovascular events following a myocardial infarction (MI) is an important area of research. Previous findings indicate flow-mediated dilatation (FMD) may be a valuable prognostic indicator. This study investigates the prognostic value of FMD in patients suffering an uncomplicated MI. METHODS: One hundred and seventy nine post-MI patients [110 male/69 female, mean age: 64.8+/-10.0 years, ejection fraction: 51.9+/-12.2%] were included in this analysis. Ultrasound images of the brachial artery were used to determine FMD following reactive hyperemia. Subjects were tracked for subsequent cardiovascular events [myocardial infarction, heart failure, additional interventions (percutaneous coronary intervention, coronary artery bypass)] following data collection via medical chart review. RESULTS: There were 45 subsequent cardiovascular events during a mean tracking period of 13.7 (+/-9.5) months. Receiver operating characteristic (ROC) curve analysis revealed a diagnosis of diabetes (ROC area: 0.67, p=0.001, 95% confidence interval: 0.58-0.77) and percent change in arterial diameter (ROC area: 0.63, p=0.01, 95% confidence interval: 0.53-0.73, optimal threshold: <or=/>4.5%) were prognostically significant. Kaplan-Meier analysis revealed the event-free survival rate for subjects without diabetes and an arterial diameter change >4.5%, without diabetes and percent change in arterial diameter <or=4.5%, with diabetes and percent change in arterial diameter >4.5% and with diabetes and percent change in arterial diameter <or=4.5% was 88.7%, 78.4%, 67.7% and 38.5%, respectively (Log-rank: 24.9, p<0.0001). CONCLUSIONS: Non-invasive FMD is a potential risk factor after MI and may add information to conventional risk stratification. This will need to be tested in further studies.
Marco Guazzi; Giuseppe Reina; Paola Gripari; Gabriele Tumminello; Marco Vicenzi; Ross Arena
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Publication Detail:
Type:  Journal Article     Date:  2008-01-03
Journal Detail:
Title:  International journal of cardiology     Volume:  132     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  45-50     Citation Subset:  IM    
University of Milano, San Paolo Hospital, Cardiopulmonary Unit, Cardiology Division, Milano, Italy.
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