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The prevalence of endothelial dysfunction in patients with and without coronary artery disease

Stefan Toggweiler1, Andreas Schoenenberger, Nadja Urbanek

  • 1Division of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland.

Clinical Cardiology
|December 25, 2010
PubMed

Insights

Endothelial dysfunction (ED) is common in chest pain patients, even without coronary artery disease (CAD). Cardiovascular risk factors significantly predict ED, highlighting the need for intensified risk factor management.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Preventive Medicine

Background:

  • Endothelial dysfunction (ED) is prevalent in patients with acute or stable coronary artery disease (CAD).
  • ED is also observed in patients experiencing chest pain but lacking angiographic coronary lesions.

Purpose of the Study:

  • To investigate the correlation between cardiovascular (CV) risk factors and ED in patients without CAD.
  • To determine if CV risk factors predict ED even in the absence of diagnosed coronary artery disease.

Main Methods:

  • A total of 341 patients undergoing coronary angiography were analyzed.
  • Endothelial function was assessed using pulse wave analysis (peripheral arterial tonometry).
  • The hyperemia ratio was calculated to quantify endothelial function post-procedure.

Main Results:

  • Patients without CAD exhibited a significantly higher hyperemia ratio (2.02 ± 0.52) compared to those with chronic (1.81 ± 0.44) or acute CAD (1.74 ± 0.49).
  • The prevalence of ED was 33% in patients without CAD, 46% with chronic CAD, and 58% with acute CAD.
  • Multivariate analysis identified CAD, diabetes, smoking, and the number of CV risk factors as strong predictors of ED. Notably, 67% of patients without CAD but with ≥3 CV risk factors had ED.

Conclusions:

  • The prevalence of ED in patients with chest pain is influenced by both the presence of CAD and the burden of CV risk factors.
  • A significant proportion of patients without CAD but with multiple CV risk factors demonstrate ED.
  • These findings suggest that patients without CAD but with multiple CV risk factors may benefit from aggressive management of their cardiovascular risk factors due to potential increased risk for future CV events.
Abstract

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