Reactive hyperemia index as an integrated marker in prediction of bleeding and cardiovascular death in ACS.

Recently, we have read with great interest Yoshii T and colleagues' article [ [1] Yoshii T. Matsuzawa Y. Kato S. et al. Endothelial dysfunction predicts bleeding and cardiovascular death in acute coronary syndrome [published online ahead of print, 2023 Feb 2]. Int. J. Cardiol. 2023; S0167-5273: 00121-00123 Google Scholar ] that was published in International Journal of Cardiology. In Yoshii T et al.'s study, they elucidated that endothelial dysfunction predicted bleeding and cardiovascular death in acute coronary syndrome (ACS). The reactive hyperemia index (RHI) was used to assess endothelial function, while RHI < 1.67 defined as endothelial dysfunction. This trial, which had the largest number of ACS patients enrolled and the longest follow-up to date according to the authors, showed that the endothelial dysfunction group had a higher risk of bleeding and cardiovascular death; However, no association with non-cardiovascular death was discovered. It's extrapolated that RHI l as a predictor for assessing bleeding and cardiovascular death in ACS.