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Endothelial dysfunction, oxidative stress, and risk of cardiovascular events in patients with coronary artery disease

T Heitzer1, T Schlinzig, K Krohn

  • 1Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Innere Medizin, Abteilung Kardiologie, Hamburg, Germany. heitzer@uke.uni-hamburg.de

Circulation
|November 28, 2001
PubMed

Insights

Impaired endothelial function and increased vascular oxidative stress are key predictors of cardiovascular events in coronary artery disease patients. Vitamin C administration showed a beneficial effect, highlighting the role of oxidative stress in disease progression.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Oxidative Stress Research

Background:

  • Endothelial dysfunction is a hallmark of coronary artery disease (CAD).
  • Increased oxidative stress is implicated in atherosclerosis and cardiovascular event pathogenesis.
  • The prognostic significance of endothelial dysfunction and vascular oxidative stress in CAD patients requires further investigation.

Purpose of the Study:

  • To determine if endothelial dysfunction and vascular oxidative stress predict cardiovascular event rates in patients with CAD.
  • To assess the impact of vitamin C on endothelial function and cardiovascular outcomes in this population.

Main Methods:

  • Forearm blood flow responses to acetylcholine and sodium nitroprusside were measured in 281 CAD patients using venous occlusion plethysmography.
  • The effect of vitamin C coadministration was evaluated in a subgroup of 179 patients.
  • Cardiovascular events were tracked over a mean 4.5-year follow-up period, with Cox regression analysis identifying independent predictors.

Main Results:

  • Patients with cardiovascular events exhibited lower vasodilator responses to both acetylcholine and sodium nitroprusside.
  • Vitamin C administration demonstrated a significant benefit in reducing cardiovascular events.
  • Blunted acetylcholine-induced vasodilation, the effect of vitamin C, and age were identified as independent predictors of cardiovascular events.

Conclusions:

  • Endothelial dysfunction and increased vascular oxidative stress are significant predictors of cardiovascular events in CAD patients.
  • These findings support the role of oxidative stress in both endothelial dysfunction and CAD activity.
  • Targeting oxidative stress may offer a therapeutic strategy for improving outcomes in coronary artery disease.
Abstract

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