Brachial artery diameter and vasodilator response to nitroglycerine, but not flow-mediated dilatation, are associated with the presence and quantity of coronary artery calcium in asymptomatic adults

Iftikhar Jan Kullo, A. Rauoof Malik, Lawrence F. Bielak, Patrick F. Sheedy, Stephen T Turner, Patricia A. Peyser

Research output: Contribution to journalArticle

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Abstract

In the present study, we investigated whether measures of brachial artery reactivity were associated with the presence and extent of subclinical coronary atherosclerosis in asymptomatic adults. Electron beam computed tomography was employed to assess the presence and quantity of CAC (coronary artery calcium) in 441 participants (mean age, 61 years; 49% men) without prior history of CHD (coronary heart disease) or stroke, and CAC score was calculated using the method described by Agatston and co-workers [(1990) J. Am. Coll. Cardiol. 15, 827-832] High-resolution ultrasound was employed to measure BAD (brachial artery diameter), FMD (flow-mediated dilatation) and NMD (nitroglycerine-mediated dilatation). CAC score and FMD were log-transformed after adding I to reduce skewness. Multivariable logistic and linear regression models based on generalized estimating equations were used to assess whether BAD, FMD and NMD were each independently associated with the presence and quantity of CAC after adjustment for CHD risk factors and use of statin and hypertension medication. CAC was detectable in 64% of participants. After adjustment for age and sex, FMD was not correlated (r = - 0.06; P = 0.27), BAD was positively correlated (r = 0.16; P = 0.004) and NMD was inversely correlated in a borderline significant manner (r = -0.10; P = 0.084) with log(CAC + I). In multivariable logistic regression analyses, FMD was not associated, whereas higher BAD (P = 0.021) and lower NMD (P = 0.030) were independently associated with the presence of CAC. In multivariable linear regression analyses, higher BAD (P = 0.004) and lower NMD (P = 0.016), but not FMD, were independently associated with log(CAC + I). We conclude that greater diameter of the brachial artery and lower vasodilator response to nitroglycerine, but not FMD, are associated with subclinical coronary atherosclerosis.

Original languageEnglish (US)
Pages (from-to)175-182
Number of pages8
JournalClinical Science
Volume112
Issue number3-4
DOIs
StatePublished - Feb 2007

Fingerprint

Brachial Artery
Nitroglycerin
Vasodilator Agents
Dilatation
Coronary Vessels
Calcium
Linear Models
Coronary Disease
Coronary Artery Disease
Logistic Models
Regression Analysis
Hydroxymethylglutaryl-CoA Reductase Inhibitors
X Ray Computed Tomography
Stroke

Keywords

  • Brachial artery diameter
  • Coronary artery calcium
  • Endothelial function
  • Flow-mediated dilatation
  • Nitroglycerine-mediated dilatation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Brachial artery diameter and vasodilator response to nitroglycerine, but not flow-mediated dilatation, are associated with the presence and quantity of coronary artery calcium in asymptomatic adults. / Kullo, Iftikhar Jan; Malik, A. Rauoof; Bielak, Lawrence F.; Sheedy, Patrick F.; Turner, Stephen T; Peyser, Patricia A.

In: Clinical Science, Vol. 112, No. 3-4, 02.2007, p. 175-182.

Research output: Contribution to journalArticle

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abstract = "In the present study, we investigated whether measures of brachial artery reactivity were associated with the presence and extent of subclinical coronary atherosclerosis in asymptomatic adults. Electron beam computed tomography was employed to assess the presence and quantity of CAC (coronary artery calcium) in 441 participants (mean age, 61 years; 49{\%} men) without prior history of CHD (coronary heart disease) or stroke, and CAC score was calculated using the method described by Agatston and co-workers [(1990) J. Am. Coll. Cardiol. 15, 827-832] High-resolution ultrasound was employed to measure BAD (brachial artery diameter), FMD (flow-mediated dilatation) and NMD (nitroglycerine-mediated dilatation). CAC score and FMD were log-transformed after adding I to reduce skewness. Multivariable logistic and linear regression models based on generalized estimating equations were used to assess whether BAD, FMD and NMD were each independently associated with the presence and quantity of CAC after adjustment for CHD risk factors and use of statin and hypertension medication. CAC was detectable in 64{\%} of participants. After adjustment for age and sex, FMD was not correlated (r = - 0.06; P = 0.27), BAD was positively correlated (r = 0.16; P = 0.004) and NMD was inversely correlated in a borderline significant manner (r = -0.10; P = 0.084) with log(CAC + I). In multivariable logistic regression analyses, FMD was not associated, whereas higher BAD (P = 0.021) and lower NMD (P = 0.030) were independently associated with the presence of CAC. In multivariable linear regression analyses, higher BAD (P = 0.004) and lower NMD (P = 0.016), but not FMD, were independently associated with log(CAC + I). We conclude that greater diameter of the brachial artery and lower vasodilator response to nitroglycerine, but not FMD, are associated with subclinical coronary atherosclerosis.",
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T1 - Brachial artery diameter and vasodilator response to nitroglycerine, but not flow-mediated dilatation, are associated with the presence and quantity of coronary artery calcium in asymptomatic adults

AU - Kullo, Iftikhar Jan

AU - Malik, A. Rauoof

AU - Bielak, Lawrence F.

AU - Sheedy, Patrick F.

AU - Turner, Stephen T

AU - Peyser, Patricia A.

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N2 - In the present study, we investigated whether measures of brachial artery reactivity were associated with the presence and extent of subclinical coronary atherosclerosis in asymptomatic adults. Electron beam computed tomography was employed to assess the presence and quantity of CAC (coronary artery calcium) in 441 participants (mean age, 61 years; 49% men) without prior history of CHD (coronary heart disease) or stroke, and CAC score was calculated using the method described by Agatston and co-workers [(1990) J. Am. Coll. Cardiol. 15, 827-832] High-resolution ultrasound was employed to measure BAD (brachial artery diameter), FMD (flow-mediated dilatation) and NMD (nitroglycerine-mediated dilatation). CAC score and FMD were log-transformed after adding I to reduce skewness. Multivariable logistic and linear regression models based on generalized estimating equations were used to assess whether BAD, FMD and NMD were each independently associated with the presence and quantity of CAC after adjustment for CHD risk factors and use of statin and hypertension medication. CAC was detectable in 64% of participants. After adjustment for age and sex, FMD was not correlated (r = - 0.06; P = 0.27), BAD was positively correlated (r = 0.16; P = 0.004) and NMD was inversely correlated in a borderline significant manner (r = -0.10; P = 0.084) with log(CAC + I). In multivariable logistic regression analyses, FMD was not associated, whereas higher BAD (P = 0.021) and lower NMD (P = 0.030) were independently associated with the presence of CAC. In multivariable linear regression analyses, higher BAD (P = 0.004) and lower NMD (P = 0.016), but not FMD, were independently associated with log(CAC + I). We conclude that greater diameter of the brachial artery and lower vasodilator response to nitroglycerine, but not FMD, are associated with subclinical coronary atherosclerosis.

AB - In the present study, we investigated whether measures of brachial artery reactivity were associated with the presence and extent of subclinical coronary atherosclerosis in asymptomatic adults. Electron beam computed tomography was employed to assess the presence and quantity of CAC (coronary artery calcium) in 441 participants (mean age, 61 years; 49% men) without prior history of CHD (coronary heart disease) or stroke, and CAC score was calculated using the method described by Agatston and co-workers [(1990) J. Am. Coll. Cardiol. 15, 827-832] High-resolution ultrasound was employed to measure BAD (brachial artery diameter), FMD (flow-mediated dilatation) and NMD (nitroglycerine-mediated dilatation). CAC score and FMD were log-transformed after adding I to reduce skewness. Multivariable logistic and linear regression models based on generalized estimating equations were used to assess whether BAD, FMD and NMD were each independently associated with the presence and quantity of CAC after adjustment for CHD risk factors and use of statin and hypertension medication. CAC was detectable in 64% of participants. After adjustment for age and sex, FMD was not correlated (r = - 0.06; P = 0.27), BAD was positively correlated (r = 0.16; P = 0.004) and NMD was inversely correlated in a borderline significant manner (r = -0.10; P = 0.084) with log(CAC + I). In multivariable logistic regression analyses, FMD was not associated, whereas higher BAD (P = 0.021) and lower NMD (P = 0.030) were independently associated with the presence of CAC. In multivariable linear regression analyses, higher BAD (P = 0.004) and lower NMD (P = 0.016), but not FMD, were independently associated with log(CAC + I). We conclude that greater diameter of the brachial artery and lower vasodilator response to nitroglycerine, but not FMD, are associated with subclinical coronary atherosclerosis.

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