title: Flow Mediated Dilatation, Carotid Intima Media Thickness, Ankle Brachial Pressure Index and Pulse Pressure in Young Male Post Myocardial Infarction Patients in India.
abstract: BACKGROUND
  Due to increase in Coronary Artery Disease (CAD) at a younger age, we should try to diagnose atherosclerotic process and population at risk, at the earliest. Flow Mediated Dilatation (FMD), Carotid Intima-Media Thickness (CIMT) and Ankle-Brachial Pressure Index (ABI) are probable markers for early atherosclerosis and may be useful in coronary risk stratification.
  
  
  OBJECTIVE
  To compare and correlate the FMD, CIMT, ABI and Pulse Pressure (PP) in young male patients of Myocardial Infarction (MI) with age and sex matched healthy controls.
  
  
  METHODS
  Eighty male patients of MI aged ≤45 years, who presented to the Cardiac Care Unit and Department of Medicine of Guru Teg Bahadur Hospital, Delhi, India, from November 2010 to April 2012 were recruited consecutively for this case control study and same number of age and sex matched healthy controls were also analyzed. Six weeks after MI, FMD of the brachial artery, intima media thickness of carotid artery, ABPI and PP were measured in the cases and compared with healthy controls.
  
  
  RESULTS
  The FMD was lower among young patients of MI than controls (p<0.001). CIMT was higher among cases than controls (p=0.001). ABI was lower among cases than controls (p<0.001). Compared to controls, PP was higher among cases (p=0.001). In all subjects, a negative correlation between FMD and CIMT (r=-0.220, p=0.005) and a positive correlation between FMD and ABPI (r=0.304, p<0.001) was found. A statistically significant negative correlation was found between endothelial dependent FMD and PP among cases and control groups (r=-0.209, p=0.007).
  
  
  CONCLUSIONS
  Biophysical parameters were deranged in young post MI patients. Majority of our young male patients fell in low risk Framingham risk score but still they manifested with CAD. Despite six weeks of treatment among young male patients of MI, various biophysical parameters were still deranged.
authors.affiliation: Senior Resident, Department of Rheumatology, CMC , Vellore, Tamilnadu, India .
authors.forename: Nikhil
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Professor, Department of Medicine, University College of Medical Sciences , Dilshad Garden, Delhi, India .
authors.forename: Subhash
authors.initials: S
authors.lastname: Giri
authors.affiliation: Professor, Department of Radio-Diagnosis, University College of Medical Sciences , Dilshad Garden, Delhi, India .
authors.forename: Vinita
authors.initials: V
authors.lastname: Rathi
authors.affiliation: Professor, Department of Medicine, University College of Medical Sciences , Dilshad Garden, Delhi, India .
authors.forename: Gajender Singh
authors.initials: GS
authors.lastname: Ranga
keywords: Biophysical parameters; Controls endothelial dysfunction; Coronary artery disease; Glyceryl trinitrate; Young myocardial infarction