title: Endothelial dysfunction, intima-media thickness, ankle-brachial pressure index, and pulse pressure in young post-myocardial infarction patients with various expressions of classical risk factors.
abstract: Coronary risk assessment based on the presence of classical risk factors may be insufficient. Several markers of arterial function and morphology, such as endothelial dysfunction (ED), intima-media thickness (IMT), ankle-brachial pressure index (ABPI), and pulse pressure (PP) may be useful in coronary risk estimation. To investigate their usefulness, we compared them in young post-myocardial infarction (MI) patients with various expressions of classical risk factors. Young male patients (on average 44 years old) in the stable phase after MI were included in the study. Twenty patients had high and 21 patients low expression of risk factors, while 25 healthy age-matched males served as controls. Endothelial dysfunction (estimated by ultrasound measurement of the flow-mediated dilation [FMD] of the brachial artery), IMT (of common carotid arteries), ABPI, and PP were compared between both groups of patients and controls. Compared with the control group, endothelial function and IMT were significantly impaired in both groups of patients, whereas ABPI was significantly reduced only in high-risk patients, and PP was similar in patients and controls. In all subjects, the level of FMD was significantly negatively related to IMT (r = -0.38, P = 0.01). Our study showed that endothelial function and IMT (but not ABPI and PP) are impaired in young post-MI patients independently of presence or absence of classical risk factors. Thus, we conclude that in young patients ED and IMT better assess coronary disease than classical risk factors, and are probably better markers of coronary risk.
authors.affiliation: Department of Vascular Disease, University Medical Centre, Zaloska 2, 1000 Ljubljana, Slovenia. erzen_b@yahoo.com
authors.forename: Barbara
authors.initials: B
authors.lastname: Erzen
authors.forename: Miso
authors.initials: M
authors.lastname: Sabovic
authors.forename: Miran
authors.initials: M
authors.lastname: Sebestjen
authors.forename: Pavel
authors.initials: P
authors.lastname: Poredos
mesh_terms: D000328:Adult; D000367:Age Factors; D000842:Ankle / Q000098:blood supply; D001783:Blood Flow Velocity / Q000502:physiology; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology*; D001916:Brachial Artery / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D017023:Coronary Angiography; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D005996:Nitroglycerin; D011237:Predictive Value of Tests; D012307:Risk Factors; D016909:Tibial Arteries / Q000503:physiopathology; D014280:Triglycerides / Q000097:blood; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018608:Ultrasonography, Doppler; D014665:Vasodilator Agents
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D014665:Vasodilator Agents; D005996:Nitroglycerin