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Differential impact of peripheral endothelial dysfunction on subsequent cardiovascular events following percutaneous coronary intervention between chronic kidney disease (CKD) and non-CKD patients

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Abstract

Chronic kidney disease (CKD) status might modify the predictive effect of peripheral endothelial dysfunction on cardiovascular events after percutaneous coronary intervention (PCI). The aim of this study was to examine the differential effect of peripheral endothelial dysfunction on clinical outcome after PCI between CKD and non-CKD patients. We conducted a cohort study of 435 patients following PCI. CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m2. Peripheral endothelial dysfunction was examined using reactive hyperemia-peripheral arterial tonometry index (RHI), and we divided patients into low- and high-natural logarithmic RHI (Ln-RHI) group. The endpoint was a composite of cardiovascular death, nonfatal myocardial infarction, ischemic stroke, hospitalization due to unstable angina pectoris, and coronary revascularization. A total of 56 patients had a cardiovascular event. Patients who suffered a cardiovascular event had significantly lower Ln-RHI than other patients in the non-CKD group (0.46 ± 0.18 versus 0.60 ± 0.25; P = 0.002). Kaplan–Meier analysis demonstrated a significantly higher probability of cardiovascular events in low Ln-RHI patients in the non-CKD group (log-rank test: P = 0.003). Multivariate Cox proportional hazards analysis identified Ln-RHI as an independent and significant predictor of future cardiovascular events in the non-CKD group (HR: 0.096; 95 % CI 0.02–0.47; P = 0.004) but not in the CKD group. There was a differential effect of peripheral endothelial dysfunction on clinical outcome after PCI between CKD and non-CKD patients, and peripheral endothelial dysfunction significantly correlates with subsequent cardiovascular events after PCI in non-CKD patients.

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References

  1. King SB 3rd, Smith SC Jr, Hirshfeld JW Jr, Jacobs AK, Morrison DA, Williams DO, Feldman TE, Kern MJ, O’Neill WW, Schaff HV, Whitlow PL, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Page RL, Riegel B, Tarkington LG, Yancy CW, ACC/AHA/SCAI (2008) 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice guidelines. J Am Coll Cardiol 51:172–209

  2. Kushner FG, Hand M, Smith SC Jr, King SB 3rd, Anderson JL, Antman EM, Bailey SR, Bates ER, Blankenship JC, Casey DE Jr, Green LA, Hochman JS, Jacobs AK, Krumholz HM, Morrison DA, Ornato JP, Pearle DL, Peterson ED, Sloan MA, Whitlow PL, Williams DO (2009) 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 54:2205–2241

    Article  PubMed  Google Scholar 

  3. Wright RS, Anderson JL, Adams CD, Bridges CR, Casey DE Jr, Ettinger SM, Fesmire FM, Ganiats TG, Jneid H, Lincoff AM, Peterson ED, Philippides GJ, Theroux P, Wenger NK, Zidar JP, Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, Chavey WE 2nd, Fesmire FM, Hochman JS, Levin TN, Lincoff AM, Peterson ED, Theroux P, Wenger NK, Wright RS (2011) 2011 ACCF/AHA focused update of the Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction (updating the 2007 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in collaboration with the American College of Emergency Physicians, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 57:1920–1959

    Article  PubMed  Google Scholar 

  4. Kuvin JT, Patel AR, Sliney KA, Pandian NG, Sheffy J, Schnall RP, Karas RH, Udelson JE (2003) Assessment of peripheral vascular endothelial function with finger arterial pulse wave amplitude. Am Heart J 146:168–174

    Article  PubMed  Google Scholar 

  5. Nohria A, Gerhard-Herman M, Creager MA, Hurley S, Mitra D, Ganz P (2006) Role of nitric oxide in the regulation of digital pulse volume amplitude in humans. J Appl Physiol 101:545–548

    Article  CAS  PubMed  Google Scholar 

  6. Rubinshtein R, Kuvin JT, Soffler M, Lennon RJ, Lavi S, Nelson RE, Pumper GM, Lerman LO, Lerman A (2010) Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events. Eur Heart J 31:1142–1148

    Article  PubMed  Google Scholar 

  7. Matsuzawa Y, Sugiyama S, Sugamura K, Nozaki T, Ohba K, Konishi M, Matsubara J, Sumida H, Kaikita K, Kojima S, Nagayoshi Y, Yamamuro M, Izumiya Y, Iwashita S, Matsui K, Jinnouchi H, Kimura K, Umemura S, Ogawa H (2010) Digital assessment of endothelial function and ischemic heart disease in women. J Am Coll Cardiol 55:1688–1696

    Article  PubMed  Google Scholar 

  8. Matsuzawa Y, Sugiyama S, Sumida H, Sugamura K, Nozaki T, Ohba K, Matsubara J, Kurokawa H, Fujisue K, Konishi M, Akiyama E, Suzuki H, Nagayoshi Y, Yamamuro M, Sakamoto K, Iwashita S, Jinnouchi H, Taguri M, Morita S, Matsui K, Kimura K, Umemura S, Ogawa H (2013) Peripheral endothelial function and cardiovascular events in high-risk patients. J Am Heart Assoc 2:e000426

    Article  PubMed  PubMed Central  Google Scholar 

  9. Gremmel T, Müller M, Steiner S, Seidinger D, Koppensteiner R, Kopp CW, Panzer S (2013) Chronic kidney disease is associated with increased platelet activation and poor response to antiplatelet therapy. Nephrol Dial Transplant 28:2116–2122

    Article  CAS  PubMed  Google Scholar 

  10. Matsue Y, Matsumura A, Abe M, Ono M, Seya M, Nakamura T, Iwatsuka R, Mizukami A, Setoguchi M, Nagahori W, Ohno M, Suzuki M, Hashimoto Y (2013) Prognostic implications of chronic kidney disease and anemia after percutaneous coronary intervention in acute myocardial infarction patients. Heart Vessels 28:19–26

    Article  PubMed  Google Scholar 

  11. Tonelli M, Muntner P, Lloyd A, Manns BJ, Klarenbach S, Pannu N, Jamus MT, Hemmelgarn BR, Network Alberta Kidney Disease (2012) Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet 380:807–814

    Article  PubMed  Google Scholar 

  12. Hirata Y, Sugiyama S, Yamamoto E, Matsuzawa Y, Akiyama E, Kusaka H, Fujisue K, Kurokawa H, Matsubara J, Sugamura K, Maeda H, Iwashita S, Jinnouchi H, Matsui K, Ogawa H (2014) Endothelial function and cardiovascular events in chronic kidney disease. Int J Cardiol 173:481–486

    Article  PubMed  Google Scholar 

  13. Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A, Collaborators developing the Japanese equation for estimated GFR (2009) Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 53:982–992

  14. Hamburg NM, Keyes MJ, Larson MG, Vasan RS, Schnabel R, Pryde MM, Mitchell GF, Sheffy J, Vita JA, Benjamin EJ (2008) Cross-sectional relations of digital vascular function to cardiovascular risk factors in the Framingham Heart Study. Circulation 117:2467–2474

    Article  PubMed  PubMed Central  Google Scholar 

  15. Selamet Tierney ES, Newburger JW, Gauvreau K, Geva J, Coogan E, Colan SD, de Ferranti SD (2009) Endothelial pulse amplitude testing: feasibility and reproducibility in adolescents. J Pediatr 154:901–905

    Article  PubMed  Google Scholar 

  16. Bonetti PO, Barsness GW, Keelan PC, Schnell TI, Pumper GM, Kuvin JT, Schnall RP, Holmes DR, Higano ST, Lerman A (2003) Enhanced external counterpulsation improves endothelial function in patients with symptomatic coronary artery disease. J Am Coll Cardiol 41:1761–1768

    Article  PubMed  Google Scholar 

  17. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, Katus HA, Lindahl B, Morrow DA, Clemmensen PM, Johanson P, Hod H, Underwood R, Bax JJ, Bonow RO, Pinto F, Gibbons RJ, Fox KA, Atar D, Newby LK, Galvani M, Hamm CW, Uretsky BF, Steg PG, Wijns W, Bassand JP, Menasché P, Ravkilde J, Ohman EM, Antman EM, Wallentin LC, Armstrong PW, Simoons ML, Januzzi JL, Nieminen MS, Gheorghiade M, Filippatos G, Luepker RV, Fortmann SP, Rosamond WD, Levy D, Wood D, Smith SC, Hu D, Lopez-Sendon JL, Robertson RM, Weaver D, Tendera M, Bove AA, Parkhomenko AN, Vasilieva EJ, Mendis S, Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction (2012) Third universal definition of myocardial infarction. Circulation 126:2020–2035

  18. Cox DA, Vita JA, Treasure CB, Fish RD, Alexander RW, Ganz P, Selwyn AP (1989) Atherosclerosis impairs flow-mediated dilation of coronary arteries in humans. Circulation 80:458–465

    Article  CAS  PubMed  Google Scholar 

  19. Ross R (1993) The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature 362:801–809

    Article  CAS  PubMed  Google Scholar 

  20. Patti G, Pasceri V, Melfi R, Goffredo C, Chello M, D’Ambrosio A, Montesanti R, Di Sciascio G (2005) Impaired flow-mediated dilation and risk of restenosis in patients undergoing coronary stent implantation. Circulation 111:70–75

    Article  PubMed  Google Scholar 

  21. Mizobe M, Hokimoto S, Akasaka T, Arima Y, Kaikita K, Morita K, Miyazaki H, Oniki K, Nakagawa K, Ogawa H (2014) Impact of CYP2C19 polymorphism on clinical outcome following coronary stenting is more important in non-diabetic than diabetic patients. Thromb Res 134:72–77

    Article  CAS  PubMed  Google Scholar 

  22. Tabata N, Hokimoto S, Akasaka T, Arima Y, Kaikita K, Kumagae N, Morita K, Miyazaki H, Oniki K, Nakagawa K, Matsui K, Ogawa H (2014) Chronic kidney disease status modifies the association of CYP2C19 polymorphism in predicting clinical outcomes following coronary stent implantation. Thromb Res 134:939–944

    Article  CAS  PubMed  Google Scholar 

  23. Kaneko H, Yajima J, Oikawa Y, Tanaka S, Fukamachi D, Suzuki S, Sagara K, Otsuka T, Matsuno S, Funada R, Kano H, Uejima T, Koike A, Nagashima K, Kirigaya H, Sawada H, Aizawa T, Yamashita T (2014) Impact of aging on the clinical outcomes of Japanese patients with coronary artery disease after percutaneous coronary intervention. Heart Vessels 29:156–164

    Article  PubMed  Google Scholar 

  24. Modena MG, Bonetti L, Coppi F, Bursi F, Rossi R (2002) Prognostic role of reversible endothelial dysfunction in hypertensive postmenopausal women. J Am Coll Cardiol 40:505–510

    Article  PubMed  Google Scholar 

  25. Bonetti PO, Lerman LO, Lerman A (2003) Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol 23:168–175

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported in part by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology, Japan.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan

    Noriaki Tabata, Seiji Hokimoto, Tomonori Akasaka, Yuichiro Arima, Kenji Sakamoto, Eiichiro Yamamoto, Kenichi Tsujita, Yasuhiro Izumiya, Megumi Yamamuro, Sunao Kojima, Koichi Kaikita & Hisao Ogawa

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  1. Noriaki Tabata
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  2. Seiji Hokimoto
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  3. Tomonori Akasaka
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  4. Yuichiro Arima
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  5. Kenji Sakamoto
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  6. Eiichiro Yamamoto
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  8. Yasuhiro Izumiya
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  9. Megumi Yamamuro
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Correspondence to Seiji Hokimoto.

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Tabata, N., Hokimoto, S., Akasaka, T. et al. Differential impact of peripheral endothelial dysfunction on subsequent cardiovascular events following percutaneous coronary intervention between chronic kidney disease (CKD) and non-CKD patients. Heart Vessels 31, 1038–1044 (2016). https://doi.org/10.1007/s00380-015-0713-x

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  • DOI: https://doi.org/10.1007/s00380-015-0713-x

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