Abstract 4508: Endothelial Dysfunction is Associated with Coronary Lesion Complexity in Patients with Coronary Artery Disease

Abstract

Endothelial dysfunction is an important step in the atherosclerosis progression, and associates with future cardiovascular events. Reactive hyperemia peripheral arterial tonometry (RH-PAT) is a noninvasive, automatic, and objective tool to evaluate endothelial dysfunction. Angiographic complex coronary lesions are involved in plaque vulnerability. We investigated whether finger values of RH-PAT could correlate with angiographic coronary plaque complexity in patients with coronary artery disease (CAD). RH-PAT was measured using Endo-PAT2000 in 171 patients who were referred to Kumamoto University Hospital for cardiac catheterization. We defined the two group as below, Control group; coronary artery stenosis > 25% (n = 36, age 63 ± 11, male 25 %), and CAD group; coronary artery stenosis > 25 % (n = 135, age 68 ± 11, male 74 %). Coronary lesions (single-vessel; n = 29, multi-vessel disease; n = 106) were classified as of simple appearance (n = 43) or complex appearance (n = 92) by coronary angiography. Values of RH-PAT were significantly lower in patients with CAD than Control (1.65 [1.50 – 1.86] versus 1.92 [1.80 – 2.28], P < 0.01), and were significantly lower in CAD patients with complex coronary appearance than patients with simple coronary appearance (1.55 [1.45 – 1.76] versus 1.81 [1.66 – 1.95], P < 0.01). All patients underwent selective coronary angiography, and the extent of coronary stenosis was assessed using the scoring system. RH-PAT was significantly correlated with coronary plaque Extent Score (Rs = −0.33, P < 0.01). Single logistic regression analysis demonstrated that high-density lipoprotein cholesterol, triglycerides, and RH-PAT value significantly associated with the presence of complex coronary lesions, and multivariable analysis including cardiovascular risk factors identified that lower RH-PAT value was the only factor associated with the complex coronary lesions (odds ratio 1.45, 95% confidence interval 1.14 – 1.84; P < 0.01). Endothelial dysfunction was significantly associated with angiographic complex appearance of coronary plaques in patients with CAD. CAD patients with lower RH-PAT values might be vulnerable patients with vulnerable plaques and vulnerable endothelium.