title: Endothelial dysfunction predicts clinical restenosis after percutaneous coronary intervention.
abstract: BACKGROUND
  Endothelial dysfunction is associated with increased risk for cardiovascular events in patients with coronary artery disease and may predict in-stent restenosis after percutaneous coronary intervention. We evaluated if endothelial dysfunction could predict clinical and angiographic restenosis in patients after percutaneous coronary intervention with stent implantation for angina pectoris or acute coronary syndrome.
  
  
  METHODS
  One hundred patients were consecutively included after successful percutaneous coronary intervention with stenting for angiographic single vessel disease. All patients were evaluated with ultrasound detection of brachial artery reactivity at four weeks and with a symptom limited exercise stress test at six months and were followed for the occurrence of clinical or angiographic restenosis for 18 ± 6 months.
  
  
  RESULTS
  Twenty patients showed clinical signs of restenosis during 18 months follow-up and were referred to re-angiography. Patients with clinical restenosis had impaired flow mediated vasodilation compared to patients without clinical restenosis (5.8 ± 3.4 vs. 9.0 ± 4.8, p = 0.005). In multivariate analysis flow mediated vasodilation was the only independent predictor for the risk of clinical restenosis (OR 4.5, 95% CI 1.11 to 17.8).
  
  
  CONCLUSIONS
  Impaired flow mediated vasodilation four weeks after percutaneous coronary intervention independently predicts the risk of clinical restenosis.
authors: Department of Cardiology, Stavanger University Hospital, Stavanger, Norway. munk@lyse.net
authors: Peter Scott
authors: PS
authors: Munk
authors: Noreen
authors: N
authors: Butt
authors: Alf Inge
authors: AI
authors: Larsen