The relationship between radial arterial spasm and adropin levels in patients undergoing radial coronary angiography

Objectives: Coronary angiography is the gold standard imaging method for the diagnosis of atherosclerotic coronary artery disease and coronary artery anomalies. Coronary angiography can be performed through various arterial sites (femoral, radial, brachial, etc.) and the frequency of complications, especially bleeding complications, is less frequent with radial angiography compared to femoral angiography, and transradial procedure seems to be associated with better outcomes. However, radial artery spasm, radial artery perforation, radial artery pseudoaneurysm, arteriovenous fistula, granuloma formation, access site bleeding, nerve damage, regional complex pain syndrome and compartment syndrome can be seen during radial angiography. Radial artery spasm is the most common complication of the transradial procedures and is a common cause of failure and transition to transfemoral intervention. Adropin is an endogenous bioactive substance that is mainly expressed in heart, brain, liver and coronary endothelial cells. Adropine increases the release of nitric oxide by increasing endothelial nitric oxide synthetase activity, induces vasodilation in the vascular wall with an indirect effect, and has a potential endothelial protective role. Low circulating levels of adropine are associated with endothelial dysfunction. The aim of our study is to investigate the effect of adropine levels on radial artery vasospasm in patients undergoing transradial coronary angiography. Therefore, the main goal was to describe whether adropin levels predict radial artery spasm in patients undergoing transradial coronary angiography. Methods: Between 15 February 2020 and 01 January 2021, among patients referred for coronary angiography in cardiology department of Tokat Gaziosmanpaşa University hospital, 39 consecutive patients who experienced radial artery spasm during transradial coronary angiography and 42 consecutive age and gender matched controls who did not experienced radial artery spasm were prospectively included in the study. Demographic characteristics of patients were recorded on admission. The serum adropin levesl of all study participants were measured and the association between adropin levels and radial artery vasospasm was investigated. Results: Although adropine levels were found to be lower in the radial artery spasm group, no statistically significant difference was observed between the groups regarding the adropin levels (p = 0.105). However, monocyte count and MHR (monocyte / HDL cholesterol ratio) levels were found to be statistically significantly higher in the radial artery spasm group compared to controls (p = 0.001 and p = 0.010, respective-ly). Conclusion: Althoug serum adropin levels were found to be lower in patients with radial artery vasospasm, there was no statistically significant difference between the groups regarding the adropin levels. However, monocyte count and MHR levels were significantly higher in patients with radial artery vasospasm compared to controls, and both inflammatory markers had a statistically significant positive correlation with radial artery vasospasm. The results of our study demonstrated that inflammatory markers that are associated with endothelial functions may provide useful information in patients undergoing transradial procedures. Keywords: Coronary artery disease, coronary angiography, radial angiography, radial artery vasospasm, adropin