Coronary endothelial dysfunction is associated with an increased risk of cerebrovascular events

Paul V. Targonski, Piero O. Bonetti, Geralyn M. Pumper, Stuart T. Higano, David Holmes, Amir Lerman

Research output: Contribution to journalArticle

223 Citations (Scopus)

Abstract

Background - Stroke, mainly attributable to atherothrombotic disease, represents a leading cause of disability and death in the Western world. Endothelial dysfunction, which is considered a key factor in atherogenesis, is associated with an increased risk of cardiovascular events. However, the magnitude of the association between coronary endothelial dysfunction (CED) and cerebrovascular events is unknown. This study was performed to investigate the association between CED and cerebrovascular events. Methods and Results - We studied 503 patients without obstructive coronary artery disease (CAD) who underwent coronary endothelial function testing by intracoronary acetylcholine infusion. Patients were divided according to the presence (n = 305) or absence (n = 198) of CED, and medical records were examined for the occurrence of ischemic of hemorrhagic stroke or transient ischemic attack either before (prevalent) or after (incident) coronary endothelial function testing. Among the study population, a total of 25 cerebrovascular events were documented, 22 in patients with CED (15 prevalent) and 3 in patients without (all prevalent) (P=0.008). Multivariable logistic regression, which included traditional cerebrovascular disease-related risk factors, identified the presence of CED as the single strongest factor associated with cerebrovascular events (OR, 4.32; 95% CI, 1.26 to 14.83). Kaplan-Meier analysis indicated that patients with CED had a significantly higher cumulative cerebrovascular event rate than those without (P=0.04). Conclusions - Presence of CED in patients without obstructive CAD is independently associated with an increased risk of cerebrovascular events. Thus, detection of this early stage of atherosclerosis may provide important information to identify patients who benefit from aggressive preventive strategies.

Original languageEnglish (US)
Pages (from-to)2805-2809
Number of pages5
JournalCirculation
Volume107
Issue number22
DOIs
StatePublished - Jun 10 2003

Fingerprint

Coronary Artery Disease
Atherosclerosis
Stroke
Cerebrovascular Disorders
Western World
Transient Ischemic Attack
Kaplan-Meier Estimate
Acetylcholine
Medical Records
Cause of Death
Logistic Models
Population

Keywords

  • Atherosclerosis
  • Endothelium
  • Epidemiology
  • Risk factors

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Coronary endothelial dysfunction is associated with an increased risk of cerebrovascular events. / Targonski, Paul V.; Bonetti, Piero O.; Pumper, Geralyn M.; Higano, Stuart T.; Holmes, David; Lerman, Amir.

In: Circulation, Vol. 107, No. 22, 10.06.2003, p. 2805-2809.

Research output: Contribution to journalArticle

Targonski, Paul V. ; Bonetti, Piero O. ; Pumper, Geralyn M. ; Higano, Stuart T. ; Holmes, David ; Lerman, Amir. / Coronary endothelial dysfunction is associated with an increased risk of cerebrovascular events. In: Circulation. 2003 ; Vol. 107, No. 22. pp. 2805-2809.
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