title: Arterial stiffness predicts risk for long-term recurrence in patients with type 2 diabetes admitted for acute coronary event.
abstract: OBJECTIVE
  to investigate the predictive value of arterial stiffness (AS) estimation for long-term recurrences in patients with type 2 diabetes (DM2) following acute coronary event.
  
  
  METHODS
  prospective observational study involving 119 DM2 patients without history of coronary heart disease admitted with ST-segment elevation myocardial infarction (STEMI). Medical history, anthropometrics, smoking, HbA1c, lipid profile, troponine-I levels, and left ventricular ejection fraction (LVEF) were recorded. Carotid-femoral pulse wave velocity (cf-PWV) was measured 1 month after discharge. Patients were followed up for 36 months or to reach an end-point: cardiovascular death, acute coronary event, angioplasty or hospitalization for acute heart failure. To facilitate analysis, patients were divided into two groups according to cf-PWV, using the accepted cut-off value of 12m/s.
  
  
  RESULTS
  overall, 34 patients had a recurrence. In Kaplan-Meier analysis patients with cf-PWV>12m/s had mean time-to-event 353±43 days compared to 505±115 days for patients with cf-PWV≤12m/s, log rank=0.0252. In multivariate analysis factors independently associated with recurrence were age (66.53±6.87 vs. 61.54±10.77 years, p=0.015), LVEF (41.66±8.21 vs. 47.58±8.11%, p=0.001) and cf-PWV (13.94±2.91 vs. 12.35±2.77m/s, p=0.008).
  
  
  CONCLUSIONS
  AS estimation in patients with DM2 after STEMI discriminate patients at higher risk for 3-year recurrence, and maybe valuable for distinguishing patients likely to require a more rigorous therapeutic intervention.
authors.affiliation: 2nd Department of Internal Medicine, Nikea General Hospital, 3 D.Mantouvalou str, Nikea, Greece. dimlevi@yahoo.gr
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Levisianou
authors.forename: Stefanos
authors.initials: S
authors.lastname: Foussas
authors.forename: Elias
authors.initials: E
authors.lastname: Skopelitis
authors.forename: Evdokia
authors.initials: E
authors.lastname: Adamopoulou
authors.forename: Theodora
authors.initials: T
authors.lastname: Xenopoulou
authors.forename: Antonios
authors.initials: A
authors.lastname: Destounis
authors.forename: Georgios
authors.initials: G
authors.lastname: Koukoulis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Skoularigis
authors.forename: Andreas
authors.initials: A
authors.lastname: Melidonis
authors.forename: Filippos
authors.initials: F
authors.lastname: Triposkiadis
mesh_terms: D054058:Acute Coronary Syndrome / Q000503:physiopathology*; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012008:Recurrence; D059289:Vascular Stiffness; D016277:Ventricular Function, Left