Association between lipid profile and endothelial dysfunction as assessed by the reactive hyperemia index
Kenji Norimatsu1,2, Koki Gondo1, Takaaki Kusumoto1
1Department of Cardiology, Izumi General Medical Center , Kagoshima, Japan.
Insights
Endothelial dysfunction (ED) is linked to higher LDL-C/HDL-C ratios in patients without dyslipidemia. Among statin users, lower HDL-C levels independently predict ED.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Diagnostic Imaging
Background:
- Endothelial dysfunction (ED) is a precursor to atherosclerosis.
- Reactive hyperemia index (RHI) via Endo-PAT2000® assesses ED.
- Investigating ED links to cardiovascular risk factors is crucial.
Purpose of the Study:
- To determine associations between ED (RHI) and atherosclerotic risk factors.
- To identify independent predictors of ED in patients undergoing coronary angiography.
- To analyze ED markers in statin-treated patients.
Main Methods:
- 191 patients undergoing coronary angiography with Endo-PAT2000® were studied.
- Patients were categorized into ED (RHI<1.67) and non-ED (RHI≥1.67) groups.
- Multivariate logistic regression analyzed predictors of ED.
Main Results:
- Older age and higher LDL-C/HDL-C (L/H) ratio were independent markers of ED.
- In statin-treated patients, lower HDL-C and older age predicted ED.
- ED group was older with a higher L/H ratio.
Conclusions:
- L/H ratio is an independent marker for ED in patients without dyslipidemia.
- HDL-C is an independent marker for ED in patients on statin therapy.
- RHI assessment aids in identifying ED and associated risk factors.
Introduction:
We investigated the associations between endothelial dysfunction (ED) as evaluated by the reactive hyperemia index (RHI) obtained using Endo-PAT2000® and atherosclerotic risk factors in patients who underwent coronary artery angiography (CAG).
Methods:
The subjects consisted of 191 patients who were clinically suspected to have CAD and underwent CAG, and in whom we could perform Endo-PAT2000®. We divided the patients into ED (RHI<1.67, n = 71) and non-ED (RHI≥1.67, n = 120) groups.
Results:
The ED group was significantly older and showed a higher ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C) (L/H) than the non-ED group. A multivariate logistic regression analysis was performed to examine the associations between the presence of ED and age, gender, and BMI in addition to L/H. Age [odds ratio (OR) = 1.03, p = .02] and L/H (OR = 1.64, p = .01) were identified as significant independent markers of the presence of ED. Next, we divided 122 patients with statin treatment into ED (n = 40) and non-ED (n = 82) groups. The ED group tended to have higher L/H and lower HDL-C than the non-ED group. HDL-C (OR = 0.95, p = .01) and age (OR = 1.05, p = .04) were identified as independent markers of the presence of ED.
Conclusions:
L/H was an independent marker of the presence of ED in patients without dyslipidemia. In addition, among patients with statin treatment, HDL-C was an independent marker of the presence of ED.
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