title: Endothelial function and left ventricular remodeling in diabetic and non-diabetic patients after acute coronary syndrome.
abstract: BACKGROUND
  Endothelial dysfunction is an independent predictor of future cardiac events.
  
  
  METHODS
  We evaluated the relationship between flow-mediated dilation (FMD) in brachial artery and coronary risk factors in 93 patients (70 males, mean age: 62 ± 8 years) with ACS treated with primary angioplasty (PCI). The patients were divided into 2 subgroups: 43 patients with diabetes mellitus type 2 (DM) and 50 non-diabetics (non-DM). Patients were examined on the 3rd day after ACS and after 6 months. FMD on the 3rd day were significantly lower in DM than in non-DM (5.8 ± 2.2% vs. 8.8 ± 4.9%, p=0.0007) and after 6 months (6.2 ± 2.6% vs. 9.4 ± 4.4%, p<0.0001). It was also observed that the improvement of FMD in both groups after a 6-month follow-up inversely correlated with the increase of left ventricular end-diastolic volume (LVEDV) (r=-0.41, p<0.001).
  
  
  RESULTS
  There was an inverse relationship between FMD and age (r=-0.26, p<0.01), BMI (r=-0.26, p<0,005), total cholesterol (r=-0.56, p<0.001) and LDL cholesterol (r=-0.53, p<0.001). There was no relationship between triglycerides, hypertension and history of smoking. In the DM group, FMD negatively correlated with HbA1c (r=-0.68, p<0.001). Restenosis rate was significantly higher in the DM group (19% vs. 6%, p<0.001) but there was no relationship between FMD and restenosis.
  
  
  CONCLUSIONS
  Impaired FMD is more significant in diabetics than in non-diabetic patients with ACS. Lack of improvement of FMD after acute coronary syndrome can be a predictor of detrimental left ventricular remodeling in patients with ACS.
authors.affiliation: Department of Invasive Cardiology and Cardiodiabetology, Medical University of Lodz, Lodz, Poland. abissinger@gmail.com
authors.forename: Andrzej
authors.initials: A
authors.lastname: Bissinger
authors.forename: Tomasz
authors.initials: T
authors.lastname: Grycewicz
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Grabowicz
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lubiński
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000503:physiopathology*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003326:Coronary Circulation / Q000502:physiology; D023903:Coronary Restenosis / Q000150:complications / Q000503:physiopathology; D003331:Coronary Vessels / Q000503:physiopathology; D003710:Demography; D048909:Diabetes Complications / Q000150:complications* / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014664:Vasodilation / Q000502:physiology; D020257:Ventricular Remodeling / Q000502:physiology*