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Article: Gender differences on brachial flow-mediated dilation and carotid intima-media thickness for prediction of spontaneous cardiovascular events.

TitleGender differences on brachial flow-mediated dilation and carotid intima-media thickness for prediction of spontaneous cardiovascular events.
Authors
Issue Date2008
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.org
Citation
Clinical Cardiology, 2008, v. 31 n. 11, p. 525-530 How to Cite?
AbstractBACKGROUND: Impaired brachial flow-mediated dilation (FMD) and increased carotid intima-media thickness (IMT) are associated with increased risk of cardiovascular events. METHODS: We measured brachial FMD and a mean of 12 sites maximum carotid IMT (mmIMT) in 279 patients (mean age 62 +/- 12 y; 163 men) admitted for coronary angiography due to chest pain. HYPOTHESIS: There are gender differences in the predictive values of FMD and IMT for cardiovascular events. RESULTS: Univariable analysis showed that impaired FMD (p < 0.001), but not increased mmIMT (p = 0.056), significantly predicted spontaneous cardiovascular events. After adjusting for the extent of coronary artery disease (CAD) and other clinical variables, age (heart rate [HR] 1.05, 95% confidence interval [CI]: 1.01-1.09, p = 0.017) and FMD (HR 0.85, 95% CI: 0.75-0.97, p = 0.012) were independent predictors for cardiovascular events. A total of 148 (53%) patients had CAD (> or =50% diameter stenosis). Over a median follow-up of 16 mo, 36 (12.9%) patients experienced spontaneous cardiovascular events (cardiovascular death, stroke, acute myocardial infarction [MI], unstable angina pectoris, and congestive heart failure [HF]). Women were more likely than men to develop cardiovascular events in patients without significant CAD (11.9% versus 1.6%, odds ratio [OR] = 8.54, p = 0.033), but not in those patients with CAD (20.4 % versus 17.2%, OR = 1.24, p = 0.66). Moreover, women accounted for 8 (88.9%) events in non-CAD patients. Furthermore, impaired FMD predicted the occurrence of cardiovascular events in both men and women (p < 0.05). CONCLUSION: Brachial FMD, rather than carotid IMT, was an independent predictor for cardiovascular events after adjusting for the extent of CAD. Moreover, impaired brachial endothelial function in women without significant CAD was associated with an increased risk of spontaneous cardiovascular events. Copyright 2008 Wiley Periodicals, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/163231
ISSN
2014 Impact Factor: 2.586
2013 SCImago Journal Rankings: 1.003
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorHu, Ren_US
dc.contributor.authorWang, WQen_US
dc.contributor.authorLau, CPen_US
dc.contributor.authorTse, HFen_US
dc.date.accessioned2012-09-05T05:29:00Z-
dc.date.available2012-09-05T05:29:00Z-
dc.date.issued2008en_US
dc.identifier.citationClinical Cardiology, 2008, v. 31 n. 11, p. 525-530en_US
dc.identifier.issn0160-9289en_US
dc.identifier.urihttp://hdl.handle.net/10722/163231-
dc.description.abstractBACKGROUND: Impaired brachial flow-mediated dilation (FMD) and increased carotid intima-media thickness (IMT) are associated with increased risk of cardiovascular events. METHODS: We measured brachial FMD and a mean of 12 sites maximum carotid IMT (mmIMT) in 279 patients (mean age 62 +/- 12 y; 163 men) admitted for coronary angiography due to chest pain. HYPOTHESIS: There are gender differences in the predictive values of FMD and IMT for cardiovascular events. RESULTS: Univariable analysis showed that impaired FMD (p < 0.001), but not increased mmIMT (p = 0.056), significantly predicted spontaneous cardiovascular events. After adjusting for the extent of coronary artery disease (CAD) and other clinical variables, age (heart rate [HR] 1.05, 95% confidence interval [CI]: 1.01-1.09, p = 0.017) and FMD (HR 0.85, 95% CI: 0.75-0.97, p = 0.012) were independent predictors for cardiovascular events. A total of 148 (53%) patients had CAD (> or =50% diameter stenosis). Over a median follow-up of 16 mo, 36 (12.9%) patients experienced spontaneous cardiovascular events (cardiovascular death, stroke, acute myocardial infarction [MI], unstable angina pectoris, and congestive heart failure [HF]). Women were more likely than men to develop cardiovascular events in patients without significant CAD (11.9% versus 1.6%, odds ratio [OR] = 8.54, p = 0.033), but not in those patients with CAD (20.4 % versus 17.2%, OR = 1.24, p = 0.66). Moreover, women accounted for 8 (88.9%) events in non-CAD patients. Furthermore, impaired FMD predicted the occurrence of cardiovascular events in both men and women (p < 0.05). CONCLUSION: Brachial FMD, rather than carotid IMT, was an independent predictor for cardiovascular events after adjusting for the extent of CAD. Moreover, impaired brachial endothelial function in women without significant CAD was associated with an increased risk of spontaneous cardiovascular events. Copyright 2008 Wiley Periodicals, Inc.en_US
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.orgen_US
dc.relation.ispartofClinical cardiologyen_US
dc.subject.meshAge Factorsen_US
dc.subject.meshBrachial Arteryen_US
dc.subject.meshCardiovascular Diseases - Pathology - Physiopathologyen_US
dc.subject.meshCarotid Arteries - Pathologyen_US
dc.subject.meshConfidence Intervalsen_US
dc.subject.meshCoronary Artery Disease - Pathology - Physiopathologyen_US
dc.subject.meshEndothelium, Vascular - Pathology - Physiopathologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Rateen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPrognosisen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSeverity Of Illness Indexen_US
dc.subject.meshSex Factorsen_US
dc.subject.meshTunica Intima - Pathologyen_US
dc.subject.meshTunica Media - Pathologyen_US
dc.subject.meshVasodilationen_US
dc.titleGender differences on brachial flow-mediated dilation and carotid intima-media thickness for prediction of spontaneous cardiovascular events.en_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1002/clc.20314-
dc.identifier.pmid19006116en_US
dc.identifier.scopuseid_2-s2.0-60849136650en_US
dc.identifier.hkuros140844-
dc.identifier.volume31en_US
dc.identifier.issue11en_US
dc.identifier.spage525en_US
dc.identifier.epage530en_US
dc.identifier.isiWOS:000260947300004-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridHu, R=55163131900en_US
dc.identifier.scopusauthoridWang, WQ=7501758106en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US

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