Endothelial dysfunction by brachial artery flow-mediated dilatation as predictor of major adverse cardiovascular event in acute coronary syndrome
Keywords:
acute coronary syndrome, flow-mediated dilatation, endothelial dysfunction, major adverse cardiovascular eventAbstract
Endothelial dysfunction (ED) is the earliest marker in the process of atherosclerosis formation and is thought to be a risk predictor of acute coronary syndrome (ACS) outcome. Our aim is to analyse the ED by brachial artery flow-mediated dilatation (FMD) as a predictor of major adverse cardiovascular event (MACE) in ACS patients. This is a prospective cohort study with consecutive sampling for ACS in a hospital at Indonesia in April-May, 2021. 69 patients who met the inclusion were examined for brachial artery FMD with value <5% stated as ED. MACE was observed during in-hospital, 1 month, and 6 months after hospitalization, and analysed using bivariate analysis and multivariate logistic regression analysis. From bivariate analysis, significant result was found for FMD <5% (RR 7,13; 95%CI=2,07-24,58; p=0.001) with 1 month of follow-up MACE and diabetes mellitus (RR 2,57; 95%CI=1,15-5,73; p=0,043) and FMD <5% (RR=5,60; 95%CI=2,44-12,86; p<0.001) with 6 months of follow-up MACE. In multivariate analysis, FMD <5% was found as the most significant predictor of 1 month and 6 months follow-up MACE. ED by brachial artery FMD was an important independent predictor of the MACE during 1 month and 6 months follow-up after ACS and might be useful for risk stratification outcome.
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