Abstract 5813: Vascular Function Measured By Digital Thermal Monitoring Strongly Correlates with the Severity of Coronary Artery Disease Diagnosed by 64 Slice Multidetector Computed Tomography

Abstract

Background: Digital Thermal Monitoring (DTM) of vascular reactivity is a new test of vascular function that correlates well with the Framingham Risk Score and subclinical coronary artery disease measured by the coronary calcium score. This study evaluates whether DTM correlates with the severity of coronary artery disease (CAD) measured by 64 slice multidetector computed tomography (MDCT). Methods: 151 patients, mean age 64±9 years, 69% male, were studied. Each underwent DTM during a 5 minute supra systolic arm-cuff occlusion and MDCT. Post-cuff deflation fingertip temperature rebound (TR) was correlated with CAD severity assessed by MDCT. Results: After adjusting for age, gender and CAD risk factors using logistic regression analysis, the odds ratio for TR in the lowest tertile vs. upper 2 tertiles was 1.3 (95% CI 0.89 –1.6, p=0.4) for mild CAC (luminal stenosis<30%), 2.7 (95% CI 1.2–3.9, p=0.0001) for moderate CAD (30 –70% luminal stenosis) and 6.94 (95% CI 2.2–10.7, p=0.0001) for severe CAD (luminal stenosis>70%) compared to normal coronaries. Additionally, TR was lower in coronary segments with mixed plaque compared to calcified plaque (0.43±0.17 vs. 0.91±0.19, p=0.001). Conclusions: Vascular dysfunction measured by DTM strongly correlates with the severity and characteristics of coronary plaques measured by MDCT, independent of age, gender and cardiac risk factors. DTM may be a useful tool for the identification of high risk patients, additional studies are warranted.