PMID- 38436050
OWN - NLM
STAT- Publisher
LR  - 20240304
IS  - 1473-5830 (Electronic)
IS  - 0954-6928 (Linking)
DP  - 2024 Mar 4
TI  - Non-invasive vascular measures as prognostic predictors for older patients with 
      non-ST elevation acute coronary syndrome.
LID - 10.1097/MCA.0000000000001352 [doi]
AB  - BACKGROUND: Adverse cardiac events are common in older patients with non-ST 
      elevation acute coronary syndrome (NSTEACS), yet prognostic predictors are still 
      lacking. This study investigated the long-term prognostic significance of 
      non-invasive measures including endothelial function, carotid intima-media 
      thickness (CIMT), and vascular stiffness in older NSTEACS patients referred for 
      invasive treatment. METHODS: NSTEACS patients aged 75 years and older recruited 
      to a multicentre cohort study (NCT01933581) were assessed for baseline 
      endothelial function using endoPAT logarithm of reactive hyperemia index (LnRHI), 
      CIMT using B-mode ultrasound, and vascular stiffness using carotid-femoral pulse 
      wave velocity (cfPWV). Long-term outcomes included major adverse cardiovascular 
      events (MACE), a composite of death, reinfarction, urgent revascularization, 
      stroke/transient ischemic attack, and significant bleeding. RESULTS: Recruitment 
      resulted in 214 patients assessed for LnRHI, 190 patients assessed for CIMT and 
      245 patients assessed for cfPWV. For LnRHI group (median follow-up 4.73 years 
      [IQR: 1.41-5.00]), Cox regression analysis revealed a trend towards increased 
      risk of MACE (HR: 1.24 [95% CI: 0.80-1.93]; P = 0.328) and mortality (HR: 1.49 
      [95% CI: 0.86-2.59]; P = 0.157), but no significance was reached. No difference 
      for other components of MACE was found. For CIMT group (median follow up 4.74 
      years [IQR: 1.55-5.00]), no statistically significant difference in MACE was 
      found (HR: 0.92 [95% CI: 0.53-1.59]; P = 0.754). Similarly, for cfPWV group 
      (median follow-up 4.96 years [IQR: 1.55-5.00]), results did not support 
      prognostic significance (for MACE, HR: 0.95 [95% CI: 0.65-1.39]; P = 0.794). 
      CONCLUSION: Endothelial function, CIMT and vascular stiffness were proven 
      unsuitable as strong prognostic predictors in older patients with NSTEACS. 
      CLINICAL TRIAL REGISTRATION: NCT01933581.
CI  - Copyright (c) 2024 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Dirjayanto, Valerie J
AU  - Dirjayanto VJ
AD  - Translational and Clinical Research Institute, Faculty of Medical Sciences, 
      Newcastle University, Newcastle upon Tyne, UK.
AD  - Faculty of Medicine, Universitas Indonesia, Indonesia, Jakarta.
FAU - Pompei, Graziella
AU  - Pompei G
AD  - Translational and Clinical Research Institute, Faculty of Medical Sciences, 
      Newcastle University, Newcastle upon Tyne, UK.
AD  - Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE.
FAU - Rubino, Francesca
AU  - Rubino F
AD  - Translational and Clinical Research Institute, Faculty of Medical Sciences, 
      Newcastle University, Newcastle upon Tyne, UK.
AD  - Division of Cardiology, Department of Medicine, University of Verona, Verona, 
      Italy.
FAU - Biscaglia, Simone
AU  - Biscaglia S
AD  - Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE.
FAU - Campo, Gianluca
AU  - Campo G
AD  - Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE.
FAU - Mihailidou, Anastasia
AU  - Mihailidou A
AD  - Department of Cardiology and Kolling Institute, Royal North Shore Hospital and 
      Macquarie University, Sydney, New South Wales, Australia.
FAU - den Ruijter, Hester
AU  - den Ruijter H
AD  - Division Heart and Lungs, Laboratory of Experimental Cardiology, University 
      Medical Center Utrecht, Amsterdam.
FAU - Kunadian, Vijay
AU  - Kunadian V
AD  - Translational and Clinical Research Institute, Faculty of Medical Sciences, 
      Newcastle University, Newcastle upon Tyne, UK.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust, Newcastle upon Tyne, UK.
LA  - eng
SI  - ClinicalTrials.gov/NCT01933581
PT  - Journal Article
DEP - 20240304
PL  - England
TA  - Coron Artery Dis
JT  - Coronary artery disease
JID - 9011445
SB  - IM
EDAT- 2024/03/04 06:50
MHDA- 2024/03/04 06:50
CRDT- 2024/03/04 05:11
PHST- 2024/03/04 06:50 [medline]
PHST- 2024/03/04 06:50 [pubmed]
PHST- 2024/03/04 05:11 [entrez]
AID - 00019501-990000000-00203 [pii]
AID - 10.1097/MCA.0000000000001352 [doi]
PST - aheadofprint
SO  - Coron Artery Dis. 2024 Mar 4. doi: 10.1097/MCA.0000000000001352.