Flow-mediated dilatation has no independent prognostic effect in patients with chest pain with or without ischaemic heart disease.

OBJECTIVE

The purpose of this study was to assess the prognostic effect of flow-mediated dilatation (FMD) in patients with chest pain admitted to a coronary care unit.

METHODS

Endothelium-dependent FMD in the brachial artery was examined in 223 patients with acute chest pain. All patients underwent a stress test at the time of admittance. On the basis of a positive stress test, a prior myocardial infarction (MI), prior percutaneous coronary intervention (PCI) or coronary bypass surgery (CABG), 137 patients were categorized as having ischaemic heart disease (IHD).

RESULTS

Patients with IHD had significantly lower FMD than patients without IHD (p=0.002). During a mean follow-up of 4.2 years, 90 patients had an endpoint event, i.e. cardiovascular death, acute MI, unstable angina pectoris, PCI or CABG. In univariate analysis, FMD <3 % was associated with an increased hazard of the combined endpoint (p=0.04). In multivariate analysis, adjusted for age, gender, IHD and body mass index, no association between FMD and the combined endpoint was found (p=0.99).

CONCLUSION

FMD is associated with IHD, but has no independent prognostic effect in patients with chest pain.