Brachial flow-mediated vasodilatation in predicting the complexity of coronary artery disease

Goal: A number of atherosclerosis risk factors have been identified, but it remains difficult to predict how these factors interact in determining the endothelial function and development of coronary artery disease (CAD). Non-invasive assessment of endothelial function is commonly undertaken using the flow-mediated vasodilatation (FMD) technique. The use of FMD as a surrogate indicator for the complexity of CAD remains largely unknown. This study aimed to determine the correlation between FMD with the complexity of CAD based on SYNTAX score for better and simpler diagnostic tools. Methodology: This was a cross-sectional study with purposive sampling. We collected data from a patient who underwent coronary angiography from October to December 2015. The SYNTAX score was calculated to determine the complexity of CAD. Endothelial function was evaluated by FMD using brachial artery Doppler ultrasonography. Correlation between FMD and SYNTAX score was evaluated using the Pearson correlation test. Result: We enrolled 40 CAD patients admitted to cardiology ward of Dr. Soetomo General Hospital, mean age 55.38±9.27 years old, 85% (n = 34) male, 67% (n = 27) has hypertension, 80% (n = 32) has high risk Framingham score, and 27.5% (n = 21) has moderate risk according SCORE score. Pre-catheterization diagnosis was post-acute coronary syndrome in 65% (n = 27) with the mean SYNTAX score being 33.21 ± 10.86. There was a strong negative and significant correlation between FMD and SYNTAX score (r = –0,787 and p <0,0001). The lower the FMD value predicts the higher complexity of CAD. Conclusion: FMD has a strong and negative correlation with the complexity of CAD based on SYNTAX score. The lower the FMD value predicts the higher complexity of CAD.