Association between coronary artery disease severity and videocapillaroscopic findings of nail fold capillary circulation

Abstract

Aim: Endothelial dysfunction plays a significant role in the etiology of coronary artery disease (CAD), which develops due to atherosclerosis, and is a major cause of morbidity and mortality. Nail fold videocapillaroscopy (NVC) assessment is a surrogate marker of endothelial dysfunction. To the best of our knowledge, the relationship between the microcirculation features on NVC and the severity of coronary atherosclerosis has not previously been investigated. In this study, we aimed to investigate the relationship between severity of coronary atherosclerosis (shown by SYNTAX and Gensini scores) and NVC findings which is an indirect indicator of systemic endothelial damage.
Methods: The study was designed as a retrospective cohort. One-hundred consecutive patients who underwent coronary angiography (CAG) and had at least one lesion in the epicardial coronary arteries, narrowing the lumen by more than 50%, were included. Coronary angiographic images of the patients were evaluated by two experienced interventional cardiologists and SYNTAX and Gensini scores were calculated. Patients were divided into three groups according to the SYNTAX scores (SYNTAX score ≤22, between 23-32, and ≥33) and two groups according to Gensini scores (Gensini score ≥30 and ˂30). The NVC examinations were performed by a rheumatologist who was experienced in this field, and the reduction in capillary density, presence of dilated capillaries, giant capillary, microhemorrhage, branching, disorganization, tortuosity, avascular area, extravasation, and neoangiogenesis were investigated.
Results: Dilated capillary vessels were more common in diabetic patients (85%) than in non-diabetics (66.7%) (P=0.041). Besides, there was no significant difference in NVC parameters between patients with and without diabetes mellitus (P>0.05 for all), with and without hypertension (P>0.05 for all). There was no significant difference between the SYNTAX groups in terms of NVC findings (P>0.05 for all). The NVC findings were similar between Gensini groups (P>0.05 for all).
Conclusion: The severity of atherosclerosis surrogated by SYNTAX and Gensini scores was not related to the NVC findings. Therefore, NVC is inappropriate for determining the severity of CAD.