Relationship between endothelial activation and stress index and radial artery occlusion in patients undergoing radial access percutaneous coronary intervention


Özkoç M., Aydemir S., Özmen M., Ocak A.

Journal of Cardiothoracic Surgery, vol.21, no.1, 2026 (SCI-Expanded, Scopus)

  • Publication Type: Article / Article
  • Volume: 21 Issue: 1
  • Publication Date: 2026
  • Doi Number: 10.1186/s13019-026-04436-8
  • Journal Name: Journal of Cardiothoracic Surgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
  • Keywords: Radial Artery Occlusion, EASIX, Transradial Coronary Angiography, Endothelial Damage
  • Ataturk University Affiliated: Yes

Abstract

Background: One of the most common complications observed after transradial coronary angiography is radial artery occlusion (RAO). Endothelial damage plays an important role in the pathophysiology of RAO. Aims: In our study, we plan to investigate the predictive value of the endothelial activation and stress index (EASIX), which is considered an indirect marker of endothelial damage, for RAO. Methods: Our study was designed as a retrospective study and includes patients who underwent transradial coronary angiography and percutaneous coronary intervention in our clinic. EASIX values were calculated from blood tests taken before the procedure. The primary endpoint of our study was determined as RAO and patients were divided into two groups according to RAO status. Variables independently associated with RAO were determined using logistic regression analysis. To evaluate the predictive capacity of the EASIX for RAO, ROC-Curve analysis was applied and the area under the curve was determined. Results: Our study included 2342 patients. The RAO rate in the sample was 3.3% (78 patients). As a result, EASIX was independently associated with RAO (P = 0.009) and predicted RAO with a cut-off value of 1.2, 76.9% sensitivity and 77.1% specificity in ROC-Curve analysis (AUC: 0.803, 95% CI: 0.755–0.851, P < 0.001). Conclusion: In our study, we observed that EASIX was an independent predictor of RAO after transradial intervention. We believe that EASIX may be useful in early detection of patients at high risk of developing RAO, especially before transradial catheterization, and in taking the necessary precautions against this complication.