Table 1.
Studies of cardiovascular events in patients with endothelial dysfunction and early or stable coronary artery disease
| Study | Population | Number | Method | Endpoints | Results |
|---|---|---|---|---|---|
| NOMAS39 | Asymptomatic, >40 years old | 819 | FMD | MACE (Stroke + MI + CV death) | OR 2.89 for patients with endothelial dysfunction and metabolic syndrome; OR 1.64 (NS) for endothelial dysfunction alone. |
| Cardiovascular Health Study40 | Asymptomatic, elderly (72–98 years old) | 2792 | FMD | MACE, heart failure, revascularization, claudication | Event free survival at 5 years 78.3 vs. 73.6 (FMD >median vs. FMD <median) P = 0.006 |
| MESA41 | Asymptomatic | 3026 | FMD | CV death, MI, angina, revascularization, cardiac arrest, stroke | OR 0.79 FMD/unit SD; 29% correct reclassification of risk. |
| Rossi42 | Asymptomatic postmenopausal women | 2264 | FMD | MACE | OR 4.42 for lower FMD tertile vs. higher FMD tertile |
| FATE43 | Healthy, male, low-intermediate FRS | 1574 | FMD | MACE | OR 0.92, NS |
| Papaioannou37 | Asymptomatic, type 2 diabetic | 75 | FMD | Nuclear myocardial perfusion imaging | FMD >8% had a negative predictive value of 93% for myocardial ischaemia |
| PIVUS44 | Asymptomatic, over 70 years old | 1016 | Invasive brachial—FMD—radial tonometry | MACE | Invasive brachial OR 0.72/SD (P = 0.01). FMD and tonometry no prognostic value |
| Framingham third generation PAT100 | General population, Framingham 3rd generation | 1957 | PAT | Relation to CV risk factors | Correlation with male, BMI, total chol/HDL, smoking, diabetes, lipid-lowering treatment |
| Rubinhstein50 | Symptomatic; low risk stress tests or normal coronary angiogram | 270 | PAT | MACE + Revascularization + CV hospitalization | Events 48 vs. 28% at 7 years, P = 0.03 |
| Suwaidi17 | Symptomatic; no significant coronary atherosclerosis | 157 | Direct coronary | MI + CV death + heart failure + revascularization | Only patients with severe endothelial dysfunction had events (14%) |
| Schachinger47 | Symptomatic; no stenosis or single vessel | 147 | Direct coronary | MI + CV death + heart failure + revascularization + angina + stroke + peripheral revascularization | Patients with events had significantly poorer vascular response to acetylcholine |
| Halcox51 | Symptomatic; with and without CAD | 308 (132 with CAD; 176 without) | Direct coronary | CV death + AMI + unstable angina + stroke | Patients with MACE had poorer response, both micro and macrovascular |
| Heitzer52 | Documented CAD | 281 | Brachial plethysmography | CV death, MI, stroke, revascularization | Patients with events had lower responses |
| Nitenberg49 | Diabetic patients, no obstructive CAD; vs. non-diabetic controls | 72 diabetics 56 controls | Direct coronary, cold pressor test | Sudden cardiac death, MI, angina, stroke, TIA, revascularization | Diabetics with abnormal cold pressor test showed higher MACE rates |