Waist circumference reduction is more strongly correlated with the improvement in endothelial function after acute coronary syndrome than body mass index reduction.
BACKGROUND
Endothelial function predicts recurrence of adverse cardiac events in patients with acute coronary syndromes (ACS). Moreover, the recovery of endothelial function correlates with cardiac event-free survival.


OBJECTIVE
The aim of this study was to determine which clinical factors correlate with the improvement in endothelial function after ACS.


METHODS
Vascular endothelial function was assessed in 98 patients with ACS by flow-mediated dilation (FMD) of the brachial artery using high-resolution ultrasound at 2 weeks and 6 months after ACS. We measured several risk parameters including plasma markers of glucose homeostasis, lipids, and blood pressure at baseline and at 6 months after ACS. Body mass index (BMI) and waist circumference (WC) were also measured as anthropometric assessments.


RESULTS
At baseline, FMD was significantly correlated with BMI, WC, high-density lipoprotein cholesterol, the homeostasis model assessment of insulin resistance, and brachial artery diameter (r=-0.32, p=0.001; r=-0.44, p<0.0001; r=0.34, p=0.0006; r=-0.21, p=0.04; r=-0.47, p<0.0001, respectively). In a stepwise multivariate regression analysis at baseline, larger WC and brachial artery diameter were independently correlated with lower brachial artery FMD (R(2)=0.319, p<0.0001). At 6 months, the change in FMD was significantly correlated with the change in WC and BMI (r=-0.59, p<0.0001; r=-0.33, p=0.001, respectively). In a stepwise multivariate regression analysis, WC reduction was independently correlated with improved FMD (R(2)=0.349, p<0.0001).


CONCLUSIONS
WC reduction is more strongly correlated with the improvement of endothelial function after ACS than BMI reduction.
Miyazaki
Shin-ichiro
S
The Department of Cardiology, Tokushima Red Cross Hospital, 103 Irinokuchi, Komatsushima-cho, Komatsushima 773-8502, Japan. shinzoo@tokushima-med.jrc.or.jp
Hiasa
Yoshikazu
Y
Takahashi
Takefumi
T
Tobetto
Yohei
Y
Chen
Hirotoshi
H
Mahara
Keitaro
K
Ogura
Riyo
R
Miyajima
Hitoshi
H
Yuba
Ken-ichiro
K
Hosokawa
Shinobu
S
Kishi
Koichi
K
Ohtani
Ryuji
R
D054058:Acute Coronary Syndrome / Q000503:physiopathology*; D000368:Aged; D015992:Body Mass Index; D001916:Brachial Artery / Q000033:anatomy & histology; D008076:Cholesterol, HDL / Q000097:blood; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D012044:Regression Analysis; D055105:Waist Circumference
D008076:Cholesterol, HDL