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Usefulness of Brachial Artery Flow-Mediated Dilation to Predict Long-Term Cardiovascular Events in Subjects Without Heart Disease

The American journal of cardiology, 2014, Vol.113 (1), p.162-167 [Peer Reviewed Journal]

Elsevier Inc. ;2014 Elsevier Inc. ;Copyright © 2014 Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Jan 1, 2014 ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2013.08.051 ;PMID: 24169007 ;CODEN: AJCDAG

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Title:
Usefulness of Brachial Artery Flow-Mediated Dilation to Predict Long-Term Cardiovascular Events in Subjects Without Heart Disease
Author: Shechter, Michael, MD, MA ; Shechter, Alon, MD ; Koren-Morag, Nira, PhD ; Feinberg, Micha S., MD ; Hiersch, Liran, MD
Subjects: Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blood Flow Velocity ; Brachial Artery - diagnostic imaging ; Brachial Artery - physiopathology ; Cardiovascular ; Cardiovascular disease ; Cardiovascular Diseases - diagnostic imaging ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - physiopathology ; Cause of Death - trends ; Cholesterol ; Coronary vessels ; Diabetes ; Endothelium, Vascular - diagnostic imaging ; Endothelium, Vascular - physiopathology ; Female ; Follow-Up Studies ; Heart attacks ; Humans ; Incidence ; Israel - epidemiology ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Risk Factors ; Survival Rate - trends ; Time Factors ; Ultrasonography ; Vasodilation - physiology ; Young Adult
Is Part Of: The American journal of cardiology, 2014, Vol.113 (1), p.162-167
Description: Endothelial dysfunction is considered an important prognostic factor in atherosclerosis. To determine the long-term association of brachial artery flow-mediated dilation (FMD) and adverse cardiovascular (CV) events in healthy subjects, we prospectively assessed brachial FMD in 618 consecutive healthy subjects with no apparent heart disease, 387 men (63%), and mean age 54 ± 11 years. After overnight fasting and discontinuation of all medications for ≥12 hours, FMD was assessed using high-resolution linear array ultrasound. Subjects were divided into 2 groups: FMD ≤11.3% (n = 309) and >11.3% (n = 309), where 11.3% is the median FMD, and were comparable regarding CV risk factors, lipoproteins, fasting glucose, C-reactive protein, concomitant medications, and Framingham 10-year risk score. In a mean clinical follow-up of 4.6 ± 1.8 years, the composite CV events (all-cause mortality, nonfatal myocardial infarction, hospitalization for heart failure or angina pectoris, stroke, coronary artery bypass grafting, and percutaneous coronary interventions) were significantly more common in subjects with FMD ≤11.3% rather than >11.3% (15.2% vs 1.2%, p = 0.0001, respectively). Univariate analysis demonstrated that the median FMD significantly predicted CV events (odds ratio 2.78, 95% CI 1.35 to 5.71, p <0.001). Multivariate analysis, controlling for traditional CV risk factors, demonstrated that median FMD was the best independent predictor of long-term CV adverse events (odds ratio 2.93, 95% CI 1.28 to 6.68, p <0.001). In conclusion, brachial artery median FMD independently predicts long-term adverse CV events in healthy subjects with no apparent heart disease in addition to those derived from traditional risk factor assessment.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0002-9149
EISSN: 1879-1913
DOI: 10.1016/j.amjcard.2013.08.051
PMID: 24169007
CODEN: AJCDAG
Source: MEDLINE
ProQuest Central

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Usefulness of Brachial Artery Flow-Mediated Dilation to Predict Long-Term Cardiovascular Events in Subjects Without Heart Disease

Elsevier Inc. ;2014 Elsevier Inc. ;Copyright © 2014 Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Jan 1, 2014 ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2013.08.051 ;PMID: 24169007 ;CODEN: AJCDAG

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