Carotid intimal-media thickness and endothelial function in young patients with history of myocardial infarction.
OBJECTIVE
The aim of the study was to evaluate the prevalence of carotid atherosclerosis and endothelial dysfunction in 45 young patients (38 mens and 7 females) with myocardial infarction (MI), age 29-45, mean age 42+/-3 years, to verify its possible role as a marker of coronary atherosclerosis.


METHODS
Vascular echography was performed to verify the presence of carotid atherosclerosis and/or endothelial dysfunction in 45 young patients with MI and in 45 healthy control subjects well matched for age and sex.


RESULTS
We observed a normal intima media thickness (IMT) only in 30% of patients with juvenile myocardial infarction (JMI) compared with 66% in the control group (P<0.0001) and 34% of patients showed an increased IMT compared with 24% of healthy subjects (P<0.0001). Compared with control subjects, patients with JMI had lower flow-mediated reactivity of the brachial arteries (P<0.05). There was a negative linear relationship between flow-mediated dilation and IMT (P<0.001). The severity of coronary artery disease (CAD) was correlated with increased IMT and with a lower flow-mediated dilation. Finally, multiple regression analysis, demonstrated that both brachial-artery reactivity and carotid IMT were significantly and independently correlated with severity of CAD.


CONCLUSIONS
Structural (carotid atherosclerosis) and functional changes (endothelial dysfunction) were present at an early age in the arteries of persons with history of JMI.
Department of Internal Medicine, Cardiovascular and Nephro-Urological Diseases, Post-graduate School of Cardiology and Division of Cardiology, University of Palermo, University Hospital P. Giaccone, Palermo, Italy. g.coppola@unipa.it
G
G
Coppola
E
E
Corrado
D
D
Piraino
M
M
Carella
L
L
Muratori
P
P
Camarda
A
A
Di Vincenzo
G
G
Ciaramitaro
M
M
Farinella
A
A
Rotolo
S
S
Evola
E
E
Hoffmann
P
P
Assennato
S
S
Novo
D000328:Adult; D017668:Age of Onset; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D018615:Ultrasonography, Doppler, Color; D014664:Vasodilation