Relationship between endothelial function and coronary risk factors in patients with stable coronary artery disease.
BACKGROUND
Results of experimental and clinical studies suggest that both coronary artery disease (CAD) itself and its traditional risk factors lead to endothelial dysfunction. The aim of the present study was to determine which CAD risk factors sustain their contribution to endothelial dysfunction despite the presence of established CAD.


RESULTS
The study group comprised 150 patients with CAD. Using a high-resolution ultrasound, the diameter of the brachial artery at rest and during reactive hyperemia (flow-mediated dilatation, FMD%: endothelial-dependent stimulus to vasodilatation), as well as after sublingual administration of nitroglycerin (NTG%: endothelium-independent vasodilatation), was measured. The relationship between FMD% and coronary risk factors [diabetes mellitus (DM), total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, triglycerides, age, family history of premature atherosclerosis, smoking, hypertension (HT), body mass index (BMI)] was investigated. In univariate analysis there was an inverse relationship between FMD% and age (r=-0.300, p<0.001), and BMI (r=-0.230, p<0.005) and FMD% was significantly lower in diabetic patients when compared to non-diabetic patients (p<0.001). In stepwise multivariate regression analysis; FMD still correlated with DM and advanced age, but not with BMI (beta=0.065, p<0.001, beta=-0.001 p=0.002, beta=-0.087, p<0.284, respectively). FMD% was found to be not associated with hypercholesterolemia, family history of premature atherosclerosis, HT and smoking.


CONCLUSIONS
Only aging and DM were independently associated with endothelial dysfunction in patients with established CAD.
Kirma
Cevat
C
Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Education and Research Hospital, Istanbul, Turkey.
Akcakoyun
Mustafa
M
Esen
Ali Metin
AM
Barutcu
Irfan
I
Karakaya
Osman
O
Saglam
Mustafa
M
Kargin
Ramazan
R
Turkmen
Muhsin
M
Boztosun
Bilal
B
Izgi
Akin
A
Sonmez
Kenan
K
D000286:Administration, Sublingual; D000368:Aged; D000375:Aging; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage; D012039:Regional Blood Flow; D012307:Risk Factors; D014463:Ultrasonography; D014664:Vasodilation; D014665:Vasodilator Agents / Q000008:administration & dosage
D014665:Vasodilator Agents; D005996:Nitroglycerin