title: Intima-media thickness and flow-mediated dilatation in the diagnosis of coronary artery disease in perimenopausal women.
abstract: BACKGROUND
  Noninvasive diagnosis of coronary artery disease (CAD) in perimenopausal women is a considerable challenge for the clinical practice.
  
  
  OBJECTIVE
  The aim of the study was to investigate whether ultrasound examination of the endothelial function and arterial remodeling can be useful for CAD risk assessment in perimenopausal women.
  
  
  METHODS
  The study involved 65 women with chest pain and positive stress test. Based on the results of coronary angiography, they were divided into 2 groups: a study group with coronary lesions (n = 32) and a control group without coronary lesions (n = 33). The mean age was 50.3 +/-3.2 years (study group: 50.3 +/-3.5 years; control group: 50.2 +/-3.0 years; P = 0.9). Atherosclerotic risk factors were analyzed in all patients. The ultrasound examination was used to assess early atherosclerotic remodeling of the artery by measuring the intima-media thickness (IMT) and endothelial dysfunction by measuring the flow-mediated dilatation (FMD).
  
  
  RESULTS
  The IMT was significantly higher in the study group compared with controls (0.059 +/-0.01 mm vs. 0.049 +/-0.01 mm, respectively; P <0.001); FMD was significantly lower in the study group compared with controls (6.53 +/-0.98 vs. 7.89 +/-0.85, respectively; P <0.001). For IMT, the area under the receiver operating characteristic curve (AUROC) was 0.73 (95% confidence interval [CI] 0.6-0.85; P <0.001); therefore, this parameter cannot be used as a predictor of CAD. FMD with the AUROC of 0.85 (95% CI 0.76-0.94; P <0.001) had a good predictive value for CAD.
  
  
  CONCLUSIONS
  Evaluation of IMT and FMD in perimenopausal women can be a useful noninvasive diagnostic tool for CAD risk assessment.
authors.affiliation: 3rd Department of Cardiology, Medical University of Silesia, Katowice, Poland. maciejkazmierski@poczta.onet.pl
authors.forename: Maciej
authors.initials: M
authors.lastname: Kaźmierski
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Michalewska-Włudarczyk
authors.forename: Lukasz J
authors.initials: LJ
authors.lastname: Krzych
mesh_terms: D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D047648:Perimenopause; D018570:Risk Assessment; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography