PMID- 26721522
OWN - NLM
STAT- MEDLINE
DCOM- 20161214
LR  - 20161230
IS  - 1095-9319 (Electronic)
IS  - 0026-2862 (Linking)
VI  - 105
DP  - 2016 May
TI  - Endothelial dysfunction evaluated by peripheral arterial tonometry is related 
      with peak TnI values in patients with ST elevation myocardial infarction treated 
      with primary angioplasty.
PG  - 34-9
LID - S0026-2862(15)30048-0 [pii]
LID - 10.1016/j.mvr.2015.12.010 [doi]
AB  - PURPOSE: The role of endothelial-dependent function in patients with acute ST 
      elevation myocardial infarction (STEMI) is not clear. Endothelial dysfunction may 
      contribute to the pathophysiological processes occurring after STEMI and 
      influence the extension of myocardial necrosis. Endothelial-dependent dysfunction 
      evaluated by peripheral arterial tonometry (PAT) has already showed to be 
      correlated with microvascular coronary endothelial dysfunction. Our purpose was 
      to evaluate the impact of endothelial dysfunction on peak Troponin I (TnI) 
      values, as a surrogate for the extension of myocardial infarction, in patients 
      with STEMI treated with primary angioplasty (P-PCI). METHODS: 58 patients with 
      STEMI treated with P-PCI (mean age 59.0 +/- 14.0 years, 46 males) were included. 
      Endothelial function was assessed by reactive hyperaemia index (RHI) determined 
      by PAT. Patients were divided in two groups according to the previously reported 
      RHI threshold for high risk (1.67). The extension of myocardial necrosis was 
      evaluated by peak TnI levels. RESULTS: RHI median value was 1.78 (IQR0.74);25 
      patients had endothelial dysfunction (RHI b 1.67). The two groups had no 
      significant differences in age, gender, main risk factors and pain-to-balloon 
      time. Patients with an RHI b 1.67 had significant larger infarcts: TnI 73.5 ng/mL 
      (IQR 114.42 ng/mL) versus TnI 33.2 ng/mL (IQR 65.2 ng/mL); p = 0.028. On 
      multivariate analysis, the presence of an RHI b 1.67 kept significant impact on 
      TnI peak values (p=0.02). CONCLUSIONS: The presence of endothelial-dependent 
      dysfunction, assessed by PAT, is related with higher peak TnI values in STEMI 
      patients treated with P-PCI. These results strength the possibility that 
      endothelial-dependent dysfunction may be a marker of poor prognosis and 
      eventually a therapeutic target in patients with STEMI.
FAU - Baptista, Sergio Bravo
AU  - Baptista SB
AD  - Cardiology Department, Hospital Fernando Fonseca, Amadora, Portugal. Electronic 
      address: sergio.b.baptista@gmail.com.
FAU - Faustino, Mariana
AU  - Faustino M
AD  - Cardiology Department, Hospital Fernando Fonseca, Amadora, Portugal. Electronic 
      address: marianafaustino85@gmail.com.
FAU - Simoes, Joana
AU  - Simoes J
AD  - Cardiology Department, Hospital Fernando Fonseca, Amadora, Portugal.
FAU - Nedio, Maura
AU  - Nedio M
AD  - Cardiology Department, Hospital Fernando Fonseca, Amadora, Portugal.
FAU - Monteiro, Celia
AU  - Monteiro C
AD  - Cardiology Department, Hospital Fernando Fonseca, Amadora, Portugal.
FAU - Lourenco, Elsa
AU  - Lourenco E
AD  - Cardiology Department, Hospital Fernando Fonseca, Amadora, Portugal.
FAU - Leal, Paulo
AU  - Leal P
AD  - Cardiology Department, Hospital Fernando Fonseca, Amadora, Portugal.
FAU - Farto eAbreu, Pedro
AU  - Farto eAbreu P
AD  - Cardiology Department, Hospital Fernando Fonseca, Amadora, Portugal.
FAU - Gil, Victor
AU  - Gil V
AD  - Cardiology Department, Hospital Fernando Fonseca, Amadora, Portugal.
LA  - eng
PT  - Journal Article
DEP - 20151222
PL  - United States
TA  - Microvasc Res
JT  - Microvascular research
JID - 0165035
RN  - 0 (Biomarkers)
RN  - 0 (Troponin I)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Biomarkers/blood
MH  - Chi-Square Distribution
MH  - Coronary Circulation
MH  - Endothelium, Vascular/*physiopathology
MH  - Female
MH  - Fingers/*blood supply
MH  - Humans
MH  - Hyperemia/physiopathology
MH  - Linear Models
MH  - Male
MH  - Manometry/*methods
MH  - Microcirculation
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/blood/diagnosis/physiopathology/*therapy
MH  - Myocardial Reperfusion Injury/blood/*diagnosis/etiology/physiopathology
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Troponin I/*blood
MH  - Up-Regulation
OTO - NOTNLM
OT  - Acute ST elevation myocardial infarction
OT  - Endothelial dysfunction
OT  - Primary angioplasty
OT  - Reactive hyperaemia index
OT  - Troponin I
EDAT- 2016/01/02 06:00
MHDA- 2016/12/15 06:00
CRDT- 2016/01/02 06:00
PHST- 2015/04/18 00:00 [received]
PHST- 2015/11/11 00:00 [revised]
PHST- 2015/12/20 00:00 [accepted]
PHST- 2016/01/02 06:00 [entrez]
PHST- 2016/01/02 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
AID - S0026-2862(15)30048-0 [pii]
AID - 10.1016/j.mvr.2015.12.010 [doi]
PST - ppublish
SO  - Microvasc Res. 2016 May;105:34-9. doi: 10.1016/j.mvr.2015.12.010. Epub 2015 Dec 
      22.