title: Cardio-ankle vascular index may be an important marker of silent neuronal injury after percutaneous coronary angiography and intervention: a prospective observational study on diagnostic accuracy.
abstract: OBJECTIVE
  The relationship between silent neuronal injury (SNI) and arterial stiffness assessed by cardio-ankle vascular index (CAVI) has not been evaluated in patients treated with coronary angiography and intervention due to acute coronary syndrome (ACS). The aim of this study is to evaluate the value of CAVI in prediction of SNI after percutaneous coronary angiography and intervention in patients presented with ACS.
  
  
  METHODS
  Eighty-three consecutive patients presented with ACS, who underwent percutaneous coronary angiography and intervention, were included in this prospective observational study on diagnostic accuracy. Neuron specific enolase (NSE) was studied before and 18 hour after the coronary angiography and intervention. CAVI was measured by VaSera-1000 instrument. Clinical and echocardiographic characteristics were analyzed and independent predictors of SNI were evaluated. Chi-square, Student t-test, Mann-Whithney U test, correlation analysis and logistic regression analysis was used for statistical analysis.
  
  
  RESULTS
  NSE levels significantly increased after cardiac catheterization (9.82±3.22 mg/dL vs. 13.15±8.55 mg/dL, p<0.001). CAVI (OR=2.992, 95% CI: 1.494-5.713, p=0.002), left ventricular ejection fraction (LVEF) (OR=0.911, 95% CI: 0.843-0.983, p=0.017) and undergoing percutaneous coronary intervention (OR=4.430, 95% CI: 1.034-18.97, p=0.045) were the independent predictors of SNI in logistic regression analysis. The cut-off value to show SNI for CAVI was 10.45 (sensitivity=71.8%, specificity=91.5%) in receiver operator charecteristic (ROC) curve analysis. The area under curve was 0.832 (95% CI=0.746-0.918, p<0.001).
  
  
  CONCLUSIONS
  Besides undergoing PCI and having LVEF, measurement of CAVI may be a useful tool for predicting the development of SNI after percutaneous coronary angiography and intervention in patients with ACS.
authors.affiliation: Clinic of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital; Trabzon-Turkey. ahmetaykan@yahoo.com.
authors.forename: Ahmet Çağrı
authors.initials: AÇ
authors.lastname: Aykan
authors.forename: Tayyar
authors.initials: T
authors.lastname: Gökdeniz
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Bektaş
authors.forename: Faruk
authors.initials: F
authors.lastname: Boyacı
authors.forename: İlker
authors.initials: İ
authors.lastname: Gül
authors.forename: Ezgi
authors.initials: E
authors.lastname: Kalaycıoğlu
authors.forename: Engin
authors.initials: E
authors.lastname: Hatem
authors.forename: Turhan
authors.initials: T
authors.lastname: Turan
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D000842:Ankle / Q000098:blood supply*; D019540:Area Under Curve; D001783:Blood Flow Velocity; D002339:Carotid Arteries / Q000503:physiopathology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000503:physiopathology*; D004452:Echocardiography; D005263:Femoral Artery / Q000503:physiopathology*; D006801:Humans; D062645:Percutaneous Coronary Intervention; D010751:Phosphopyruvate Hydratase; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011673:Pulsatile Flow
chemical_list: D010751:Phosphopyruvate Hydratase