Association between 10-Year Atherosclerotic Cardiovascular Disease Risk and Vascular Endothelial Function in Patients with Vasospastic Angina

Abstract

<b><i>Background:</i></b> Endothelial dysfunction is a predictor of atherosclerotic cardiovascular disease (ASCVD) and plays an important role in vasospastic angina (VA). <b><i>Objectives:</i></b> This study evaluated whether flow-mediated dilation (FMD) is also a good marker of 10-year ASCVD risk (10Y-ASCVDR) in patients with VA. <b><i>Methods:</i></b> Based on their clinical history and coronary artery diameter stenosis (DS), patients were retrospectively enrolled into VA (DS &#x3c;50% and positive ergonovine provocation), minor coronary artery disease (mCAD, DS &#x3c;30%), and significant coronary artery disease (sCAD, DS ≥50%) groups. Endothelial function was evaluated by FMD. <b><i>Results:</i></b> Each group contained 50 patients. The 10Y-ASCVDR was significantly higher in the sCAD group than in the VA and mCAD groups (10.86 ± 7.30, 4.71 ± 4.04, and 4.77 ± 4.30, respectively, <i>p</i> &#x3c; 0.001). The FMD was significantly higher in the mCAD group than in the VA and sCAD groups (6.37 ± 4.25, 3.10 ± 2.23, and 3.07 ± 1.89, respectively, <i>p</i> &#x3c; 0.001). A significant correlation was found between the FMD and 10Y-ASCVD in the mCAD group (<i>r</i> = −0.622, <i>p</i> &#x3c; 0.001) and the sCAD group (<i>r</i> = −0.557, <i>p</i> &#x3c; 0.001) but not in the VA group (<i>r</i> = −0.193, <i>p</i> = 0.179). After adjusting for potential confounders such as BMI, C-reactive protein, maximal coronary stenosis, and brachial-ankle pulse wave velocity, multivariate analysis showed that FMD was independently associated with 10Y-ASCVDR in all patients. However, when looking only at the VA group, FMD did not correlate independently with 10Y-ASCVDR. <b><i>Conclusions:</i></b> Unlike mCAD and sCAD, we found no correlation between 10Y-ASCVDR and endothelial function in VA. Thus, our results support that FMD is not a good marker of atherosclerotic cardiovascular risk in VA.