TY - JOUR
T1 - The association between endothelial dysfunction and cardiovascular outcomes in a population-based multi-ethnic cohort
AU - Shimbo, Daichi
AU - Grahame-Clarke, Cairistine
AU - Miyake, Yumiko
AU - Rodriguez, Carlos
AU - Sciacca, Robert
AU - Di Tullio, Marco
AU - Boden-Albala, Bernadette
AU - Sacco, Ralph
AU - Homma, Shunichi
N1 - Funding Information:
The authors would like to thank Clarito Dimayuga for technical assistance. This work was supported by grants R01 NS-29993, K24 NS02241, and K23 HL072866 from the National Institutes of Health, and a Clinically Applied Research Grant from the American Heart Association.
PY - 2007/5
Y1 - 2007/5
N2 - Background: Brachial artery flow-mediated dilation (FMD) may predict cardiovascular events in selected high-risk patients. Whether FMD testing predicts cardiovascular events in asymptomatic, lower risk individuals from the general population is unknown. Methods and results: As a part of a multi-ethnic, prospective cohort study, the Northern Manhattan Study, we examined FMD by high-resolution ultrasonography in 842 community participants who were free of stroke or myocardial infarction. Lower FMD levels predicted cardiovascular events (myocardial infarction, stroke and vascular death) at 36 months of follow-up (hazard ratio (HR) = 1.12 for every 1% decrease in FMD, 95% CI 1.01-1.25, p = 0.03). The risk of events in patients with FMD in the lower two tertiles (FMD < 7.5%) was significantly higher than those in the highest tertile (HR = 3.28, 95% CI 1.07-10.06, p = 0.04 for lowest versus highest tertile, and HR = 3.05, 95% CI 1.03-9.66, p = 0.04 for middle versus highest tertile). In a multivariate analysis including cardiovascular risk factors, the increase in risk associated with FMD was no longer statistically significant. Conclusions: Non-invasive FMD testing predicts incident cardiovascular events in this multi-ethnic, population-based sample, but its predictive value is not independent of cardiovascular risk factors.
AB - Background: Brachial artery flow-mediated dilation (FMD) may predict cardiovascular events in selected high-risk patients. Whether FMD testing predicts cardiovascular events in asymptomatic, lower risk individuals from the general population is unknown. Methods and results: As a part of a multi-ethnic, prospective cohort study, the Northern Manhattan Study, we examined FMD by high-resolution ultrasonography in 842 community participants who were free of stroke or myocardial infarction. Lower FMD levels predicted cardiovascular events (myocardial infarction, stroke and vascular death) at 36 months of follow-up (hazard ratio (HR) = 1.12 for every 1% decrease in FMD, 95% CI 1.01-1.25, p = 0.03). The risk of events in patients with FMD in the lower two tertiles (FMD < 7.5%) was significantly higher than those in the highest tertile (HR = 3.28, 95% CI 1.07-10.06, p = 0.04 for lowest versus highest tertile, and HR = 3.05, 95% CI 1.03-9.66, p = 0.04 for middle versus highest tertile). In a multivariate analysis including cardiovascular risk factors, the increase in risk associated with FMD was no longer statistically significant. Conclusions: Non-invasive FMD testing predicts incident cardiovascular events in this multi-ethnic, population-based sample, but its predictive value is not independent of cardiovascular risk factors.
KW - Endothelial reactivity
KW - Epidemiology
KW - Risk factors
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U2 - 10.1016/j.atherosclerosis.2006.05.005
DO - 10.1016/j.atherosclerosis.2006.05.005
M3 - Article
C2 - 16762358
AN - SCOPUS:34247144576
SN - 0021-9150
VL - 192
SP - 197
EP - 203
JO - Atherosclerosis
JF - Atherosclerosis
IS - 1
ER -