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Lower Fingertip Temperature Rebound is Associated with Higher Burden of Cardiovascular Risk Factors Measured by Framingham Risk Score.

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Presentation on theme: "Lower Fingertip Temperature Rebound is Associated with Higher Burden of Cardiovascular Risk Factors Measured by Framingham Risk Score."— Presentation transcript:

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2 Lower Fingertip Temperature Rebound is Associated with Higher Burden of Cardiovascular Risk Factors Measured by Framingham Risk Score

3 Lower Fingertip Temperature Rebound is Associated with Higher Coronary Plaque Burden

4 The Combination of Low Fingertip Temperature Rebound and High Framingham Risk Score is Associated with High Risk Coronary Artery Calcium Score 4

5 VENDYS Improves Risk Stratification of High Risk Patients (CAC ≥ 100) over Traditional Risk Factor Assessment Variable AUC ± S.D. 95% CI P (compared to FRS) VENDYS + FRS 0.89 (0.02) 0.001 VENDYS 0.79 (0.03) FRS 0.66 (0.04) - - -

6 Lower Fingertip Temperature Rebound is Associated with the Presence of Cardiometabolic Disorders

7 Fingertip Temperature Rebound Decreases as the Number of Cardiometabolic Risk Factors Increases

8 VENDYS Improves Identification of High Risk Diabetic Patients (CAC ≥ 100)
DM – Diabetes Mellitus Variable AUC ± S.D. 95% CI P VENDYS + DM 0.91 (0.02) 0.0001 VENDYS 0.79 (0.03) DM 0.70 (0.03)

9 Lower Fingertip Temperature Rebound is Associated with Increased Insulin Resistance, Coronary Calcification, and Framingham Risk Score

10 In Patients with Chest Pain, Lower Fingertip Temperature Rebound is Associated with Coronary Artery Disease

11 A Combination of Low Fingertip Temperature Rebound and High Framingham Risk Score is Associated with Obstructive Coronary Artery Disease

12 A Combination of VENDYS and Framingham Risk Score May Aid Clinical Risk Assessment of Vaguely Symptomatic Patients Suspected of having Obstructive Coronary Artery Disease Variable AUC ± S.D. 95% CI P Comparison P with FRS VENDYS + FRS + CAC 0.94 (0.03) 0.0001 0.001 CACπ 0.84 (0.04) 0.003 VENDYS + FRS 0.79 (0.04) 0.009 VENDYS€ 0.74 (0.04) 0.03 FRS¥ 0.63 (0.05) - - - ∏ Coronary Artery Calcium Score: CAC: 0, 1-99, , ≥400 € Fingertip Temperature Rebound: Tertiles of VENDYS TR ¥ Framingham 10 Year CHD Risk Score (FRS): <10%, 10-20%, >20%

13 Brachial Artery Ultrasound FMD VENDYS® - Endothelix, Inc.
Moving Endothelial Function Testing out of the Research Lab and into Doctors Offices Brachial Artery Ultrasound FMD VENDYS® - Endothelix, Inc. Arm-cuff based reactive hyperemia Ultrasound measurement of brachial artery dilation 15-minute test Not automated Requires skilled operator and high-resolution ultrasound Very operator-dependent and not suitable for physicians’ offices Arm-cuff based reactive hyperemia Fingertip temperature changes 15-minute test Fully automated Does not require ultrasound equipment Operator independent and suitable for physicians’ offices

14 Brachial Artery Ultrasound FMD VENDYS® - Endothelix, Inc.
Moving Endothelial Function Testing out of the Research Lab and into Doctors Offices Brachial Artery Ultrasound FMD VENDYS® - Endothelix, Inc. Arm-cuff based reactive hyperemia Ultrasound measurement of brachial artery dilation 15-minute test Not automated Requires skilled operator and high-resolution ultrasound Very operator-dependent and not suitable for physicians’ offices Arm-cuff based reactive hyperemia Fingertip temperature changes 15-minute test Fully automated Does not require ultrasound equipment Operator independent and suitable for physicians’ offices

15 VENDYS-1 VENDYS-2 Distribution of Vascular Reactivity Index (VRI)
A histogram and cumulative percentage curve are shown.

16 VENDYS-1 VENDYS-2 Prevalence of Poor VRI in Different Age Groups
The frequency of having a poor VRI score (VRI <1.0) is shown for the three age categories of age < 50y, age 50-70y, and age >=70y.

17 VENDYS-1 VENDYS-2 Vascular Reactivity Index (VRI) and Age
A scatter plot, trend line, and Pearson’s r coefficient are shown. VRI was mildly and inversely correlated with age.

18 VENDYS-1 VENDYS-2 Distribution of Vascular Reactivity Index (VRI) by Gender The percent of DTM tests falling into categories of poor, intermediate, and good vascular reactivity is shown for men (solid fill) and women (hatch fill).

19 VENDYS-1 VENDYS-2 Distribution of Vascular Reactivity Index (VRI) in Oldest Age Group The percent of tests falling into categories of poor, intermediate, and good vascular reactivity is shown for patients age >= 70 years.

20 Selected Patient and Test Characteristics
VENDYS-1 VENDYS-2 Selected Patient and Test Characteristics Finger t300 = finger temperature at the onset of cuff occlusion (time300s); VRI = vascular reactivity index; NVRI = neurovascular reactivity index; Cold Finger = a flagged condition in which right finger t300 is equal to or less than 27°C; Sympathetic Response = a flagged condition in which left finger temperature continuously declines after right arm cuff occlusion.

21 Multiple Linear Regression – Models for VRI, SBP, and DBP
VENDYS-1 VENDYS-2 VRI (Dependent) R Square = 0.06, SE = 0.52 β p-value Intercept < 0.001 Age DBP 0.002 Male sex SBP (Dependent) R Square = 0.02, SE = 20.36 β p-value Intercept < 0.001 VRI 0.001 Age HR 0.018 Male sex 0.560 DBP (Dependent) R Square = 0.10, SE = Results are shown for four separate multiple linear regression models: VRI (vascular reactivity index), SBP (systolic blood pressure) and DBP (diastolic blood pressure). β = β coefficient; R Square = R2; SE = standard error. Units for variables were as follows: Age (y), HR (bpm), Sex (male = 1, female = 0), SBP and DBP (mm Hg).


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