Endothelial dysfunction evaluated by peripheral arterial tonometry is related with peak TnI values in patients with ST elevation myocardial infarction treated with primary angioplasty

• Published in: Microvascular research 2016-05, Vol.105, p.34-39
• Main Authors: Baptista, Sérgio Bravo, Faustino, Mariana, Simões, Joana, Nédio, Maura, Monteiro, Célia, Lourenço, Elsa, Leal, Paulo, Farto eAbreu, Pedro, Gil, Victor
• Format: Article
• Language: English
• Subjects: Acute ST elevation myocardial infarction; Adult; Aged; Biomarkers - blood; Chi-Square Distribution; Coronary Circulation; Endothelial dysfunction; Endothelium, Vascular - physiopathology; Female; Fingers - blood supply; Humans; Hyperemia - physiopathology; Linear Models; Male; Manometry - methods; Microcirculation; Middle Aged; Multivariate Analysis; Myocardial Infarction - blood; Myocardial Infarction - diagnosis; Myocardial Infarction - physiopathology; Myocardial Infarction - therapy; Myocardial Reperfusion Injury - blood; Myocardial Reperfusion Injury - diagnosis; Myocardial Reperfusion Injury - etiology; Myocardial Reperfusion Injury - physiopathology; Percutaneous Coronary Intervention - adverse effects; Predictive Value of Tests; Primary angioplasty; Prospective Studies; Reactive hyperaemia index; Risk Factors; Treatment Outcome; Troponin I; Troponin I - blood; Up-Regulation
• ISSN: 0026-2862; 1095-9319
• DOI: 10.1016/j.mvr.2015.12.010

The role of endothelial-dependent function in patients with acute ST elevation myocardial infarction (STEMI) is not clear. Endothelial dysfunction may contribute to the pathophysiological processes occurring after STEMI and influence the extension of myocardial necrosis. Endothelial-dependent dysfunction evaluated by peripheral arterial tonometry (PAT) has already showed to be correlated with microvascular coronary endothelial dysfunction. Our purpose was to evaluate the impact of endothelial dysfunction on peak Troponin I (TnI) values, as a surrogate for the extension of myocardial infarction, in patients with STEMI treated with primary angioplasty (P-PCI). 58 patients with STEMI treated with P-PCI (mean age 59.0±14.0years, 46 males) were included. Endothelial function was assessed by reactive hyperaemia index (RHI) determined by PAT. Patients were divided in two groups according to the previously reported RHI threshold for high risk (1.67). The extension of myocardial necrosis was evaluated by peak TnI levels. RHI median value was 1.78 (IQR 0.74); 25 patients had endothelial dysfunction (RHI