OBJECTIVES: We assessed the hypothesis that changes in endothelial vasomotor function in response to optimized therapy for @entity453 predict future @entity65 . BACKGROUND: Although endothelial vasomotor dysfunction is a predictor of @entity65 , it remains unclear whether reversibility of @entity409 in response to risk factor reduction provides prognostic information. METHODS: This study included 251 @entity1 with newly diagnosed @entity453 and an @entity384 ( @entity384 ) of the brachial artery ( @entity384 <5.5%). Measurement of @entity384 was repeated after 6 months for individualized and optimized therapy to reduce risk factors according to American College of Cardiology/American Heart Association guidelines. @entity1 were followed up for 36 months or until 1 of the following events occurred: @entity204 , nonfatal @entity583 , recurrent and @entity951 requiring coronary revascularization, or @entity385 . RESULTS: @entity384 was persistently impaired (<5.5%) in 104 (41%) @entity1 after 6 months of optimized therapy, whereas it improved ( @entity384 > or =5.5%) in the remaining 147 (59%) @entity1 . During 36 months of follow-up, events occurred in 27 (26%) @entity1 with persistently impaired @entity384 and in 15 (10%) @entity1 with improved @entity384 (p < 0.01 by chi-square test). Multivariate Cox hazards analysis showed that persistent impairment of @entity384 was an independent predictor of events (hazard ratio: 2.9, 95% confidence interval: 1.5 to 6.2, p < 0.01). Baseline @entity384 before the optimized therapy to reduce risk factor had no significant prognostic information. CONCLUSIONS: Persistent impairment of endothelial vasomotor function despite optimized therapy to reduce risk factors has an adverse impact on outcome in @entity453 @entity1 .

Persistent impairment of endothelial vasomotor function has a negative impact on outcome in @entity1 with XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity384 :: ('MESH:D002311', 'Disease') :: ['impaired flow-mediated dilation', 'FMD'] @entity409 :: ('MESH:D008107', 'Disease') :: ['endothelial dysfunction'] @entity951 :: ('MESH:D000787', 'Disease') :: ['refractory angina pectoris'] @entity453 :: ('MESH:D003324', 'Disease') :: ['coronary artery disease', 'atherosclerotic coronary artery disease'] @entity204 :: ('MESH:D003643', 'Disease') :: ['cardiac death'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular events'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity453 :: (MESH:D003324,Disease) :: ['coronary artery disease']
