Early and late response-to-injury in patients undergoing transradial coronary angiography: arterial remodeling in smokers

TY - JOUR

T1 - Early and late response-to-injury in patients undergoing transradial coronary angiography

T2 - arterial remodeling in smokers

AU - Sansone, Roberto

AU - Stegemann, Emilia

AU - Ozaslan, Göksen

AU - Schuler, Dominik

AU - Lukosz, Margarete

AU - Rodriguez-Mateos, Ana

AU - Lauer, Thomas

AU - Westenfeld, Ralf

AU - Kelm, Malte

AU - Heiss, Christian

PY - 2014

Y1 - 2014

N2 - OBJECTIVES: To investigate the effect of smoking on vascular response to transradial coronary angiography (TCA).BACKGROUND: Cigarette smoking is the most important modifiable cardiovascular risk factor associated with endothelial dysfunction.METHODS: Radial artery flow-mediated vasodilation (RA-FMD), local stiffness (fractional diameter change), intima-media thickness (IMT), luminal and external arterial diameter were measured in 40 current smokers (CS) and former smokers (FS) at 6-14 months at the site of previous TCA and contralateral control artery. Vascular regenerative capacity was studied as chemotactic cell migration in vitro and ex vivo (n=10) and the time course of endothelial functional recovery following RA-FMD up to 72 h after TCA (n=10).RESULTS: At 10 ± 3 months after TCA, subjects exhibited significant local stiffening and increased IMT as compared to the control arm. These late structural changes were significantly more pronounced in CS as compared to FS. IMT thickening correlated with packyears, number of daily cigarettes, and inversely with RA-FMD. Nitric oxide synthase (NOS)-dependent chemotaxis of CS' circulating angiogenic cells was impaired. Ex vivo incubation of endothelial cells with CS' plasma inhibited NOS-dependent endothelial wound closure and chemotaxis. In vivo, TCA acutely decreased RA-FMD. At 24 h, RA-FMD had recovered in FS but remained impaired at 24 h and only recovered at 48 h in CS.CONCLUSION: In active smokers, transradial coronary angiography is associated with delayed early recovery from transient endothelial dysfunction, decreased NOS-dependent vascular regeneration, and late arterial remodeling pointing towards potential harmful effects of transradial coronary angiography on vascular function in distinct subsets of patients.

AB - OBJECTIVES: To investigate the effect of smoking on vascular response to transradial coronary angiography (TCA).BACKGROUND: Cigarette smoking is the most important modifiable cardiovascular risk factor associated with endothelial dysfunction.METHODS: Radial artery flow-mediated vasodilation (RA-FMD), local stiffness (fractional diameter change), intima-media thickness (IMT), luminal and external arterial diameter were measured in 40 current smokers (CS) and former smokers (FS) at 6-14 months at the site of previous TCA and contralateral control artery. Vascular regenerative capacity was studied as chemotactic cell migration in vitro and ex vivo (n=10) and the time course of endothelial functional recovery following RA-FMD up to 72 h after TCA (n=10).RESULTS: At 10 ± 3 months after TCA, subjects exhibited significant local stiffening and increased IMT as compared to the control arm. These late structural changes were significantly more pronounced in CS as compared to FS. IMT thickening correlated with packyears, number of daily cigarettes, and inversely with RA-FMD. Nitric oxide synthase (NOS)-dependent chemotaxis of CS' circulating angiogenic cells was impaired. Ex vivo incubation of endothelial cells with CS' plasma inhibited NOS-dependent endothelial wound closure and chemotaxis. In vivo, TCA acutely decreased RA-FMD. At 24 h, RA-FMD had recovered in FS but remained impaired at 24 h and only recovered at 48 h in CS.CONCLUSION: In active smokers, transradial coronary angiography is associated with delayed early recovery from transient endothelial dysfunction, decreased NOS-dependent vascular regeneration, and late arterial remodeling pointing towards potential harmful effects of transradial coronary angiography on vascular function in distinct subsets of patients.

KW - endothelial function

KW - intima media thickness

KW - prevention

KW - smoking

KW - transradial coronary angiography

M3 - Article

C2 - 25006532

SN - 0033-0620

VL - 4

SP - 47

EP - 57

JO - Progress in Cardiovascular Diseases

JF - Progress in Cardiovascular Diseases

IS - 2

ER -