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Reactivity of skin microcirculation as a biomarker of cardiovascular events. Pilot study. BACKGROUND: The role of microcirculatory disorders is progressively being accepted in the pathogenesis of cardiovascular diseases. OBJECTIVE: The purpose of current study is to assess whether we can consider skin microcirculation disorders as a biomarker of cardiovascular events. METHODS: Group 1 consisted of healthy volunteers (n = 31); group 2 (n = 42) consisted of patients with diseases that increase the risk of cardiovascular events; group 3 (n = 39) included patients with the history of cardiovascular events. Skin microcirculation measurement was performed using laser Doppler flowmetry during the heating test. RESULTS: LDF parameters reflecting the rapid response of microcirculation to heating ("Slope 120 s" and "Slope 180 s") significantly differed in three groups (p <  0.05). A decrease in the "Slope 180 s" parameter less than 0.5 PU/s is associated with cardiovascular events (sensitivity 69.2%, specificity 66.7%; the area under the ROC curve, 0.667; 95% confidence interval [CI], 0.545-0.788, p = 0.01). Multivariable logistic regression analysis revealed that "Slope 180 s≤0.5 PU/s" was significantly related to cardiovascular events (adjusted odds ratio = 3.9, p = 0.019, CI 95% 1.2-12). CONCLUSIONS: Reduced reactivity of the skin microcirculation may be useful as a biomarker of severe damage to the cardiovascular system and is promising as a risk factor for cardiovascular events.