Diagnostic value of flow mediated dilatation measurement for coronary artery lesions in men under 45 years of age.
BACKGROUND
In those without symptoms of coronary artery disease (CAD), the incidence of coronary events is still high. The aim of this study was to evaluate whether flow mediated dilatation (FMD) is a useful tool in identifying those with CAD in who are under 45 years of age.


RESULTS
Seventy five men below 45 years of age, hospitalized in order to perform elective coronary angiography, were enrolled into the study. Based on coronary angiography findings, they were divided into two groups: study group (Group A, n = 55) with obstructive coronary lesions and the control group (Group B, n = 20) without significant lesions in coronary arteries. In all subjects atherosclerosis risk factors were analyzed. Endothelial dysfunction was assessed in ultrasound via FMD. FMD was significantly lower in the study group than in the control group (3.92 +/- 1.1 vs 6.51 +/- 1.1, p < 0.001). FMD, as well as age, diabetes and positive family history, appeared to be statistically significant CAD risk factors. AUROC for FMD was 0.957 (p < 0.001), meaning this model had an almost complete ability to predict the presence of CAD. AUROC for CAD diagnosis on the basis of significant clinical parameters was 0.992 (p < 0.001), also representing almost complete ability of this model to identify asymptomatic subjects with CAD risk.


CONCLUSIONS
The evaluation of endothelial function by the use of FMD in the population of men below 45 years of age with diabetes and positive family history can help in identifying subjects at high risk of coronary artery disease.
3rd Department of Cardiology, Medical University of Silesia, Katowice, Poland. maciejkazmierski@poczta.onet.pl
Maciej
M
Kaźmierski
Aleksandra
A
Michalewska-Włudarczyk
Lukasz J
LJ
Krzych
Michał
M
Tendera
D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin; D016017:Odds Ratio; D011044:Poland; D011237:Predictive Value of Tests; D012372:ROC Curve; D012039:Regional Blood Flow; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography; D014664:Vasodilation; D014665:Vasodilator Agents
D014665:Vasodilator Agents; D005996:Nitroglycerin