Endothelial dysfunction by brachial artery flow-mediated dilatation as predictor of major adverse cardiovascular event in acute coronary syndrome

Endothelial dysfunction (ED) is the earliest marker in the process of atherosclerosis formation and is thought to be a risk predictor of acute coronary syndrome    (ACS) outcome. Our aim is to analyse the ED by brachial artery flow-mediated dilatation (FMD) as a predictor of major adverse cardiovascular event (MACE) in ACS patients. This is a prospective cohort study with consecutive sampling for ACS in a hospital at Indonesia in April-May, 2021. 69 patients who met the inclusion were examined for brachial artery FMD with value <5% stated as ED. MACE was observed during in-hospital, 1 month, and 6 months after hospitalization, and analysed using bivariate analysis and multivariate logistic regression analysis. From bivariate analysis, significant result was found for FMD <5% (RR 7,13; 95%CI=2,07-24,58; p=0.001) with 1 month of follow-up MACE and diabetes mellitus (RR 2,57; 95%CI=1,15-5,73; p=0,043) and FMD <5% (RR=5,60; 95%CI=2,44-12,86; p<0.001) with 6 months of follow-up MACE. In multivariate analysis, FMD <5% was found as the most significant predictor of 1 month and 6 months follow-up MACE. ED by brachial artery FMD was an important independent predictor of the   MACE during 1 month and 6 months follow-up after ACS and might be useful for risk stratification outcome