Skip to main content
SpringerLink
Log in

Endothelial dysfunction, intima-media thickness, ankle-brachial pressure index, and pulse pressure in young post-myocardial infarction patients with various expressions of classical risk factors

  • ORIGINAL ARTICLE
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Coronary risk assessment based on the presence of classical risk factors may be insufficient. Several markers of arterial function and morphology, such as endothelial dysfunction (ED), intima-media thickness (IMT), ankle-brachial pressure index (ABPI), and pulse pressure (PP) may be useful in coronary risk estimation. To investigate their usefulness, we compared them in young post-myocardial infarction (MI) patients with various expressions of classical risk factors. Young male patients (on average 44 years old) in the stable phase after MI were included in the study. Twenty patients had high and 21 patients low expression of risk factors, while 25 healthy age-matched males served as controls. Endothelial dysfunction (estimated by ultrasound measurement of the flow-mediated dilation [FMD] of the brachial artery), IMT (of common carotid arteries), ABPI, and PP were compared between both groups of patients and controls. Compared with the control group, endothelial function and IMT were significantly impaired in both groups of patients, whereas ABPI was significantly reduced only in high-risk patients, and PP was similar in patients and controls. In all subjects, the level of FMD was significantly negatively related to IMT (r = −0.38, P = 0.01). Our study showed that endothelial function and IMT (but not ABPI and PP) are impaired in young post-MI patients independently of presence or absence of classical risk factors. Thus, we conclude that in young patients ED and IMT better assess coronary disease than classical risk factors, and are probably better markers of coronary risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. RA Vogel RM Benitez (2000) ArticleTitleNoninvasive assessment of cardiovascular risk: from Framingham to the future Rev Cardiovasc Med 1 IssueID1 34–42 Occurrence Handle12457150 Occurrence Handle1:STN:280:DC%2BD38nps1Clug%3D%3D

    PubMed  CAS  Google Scholar 

  2. PW Wilson RB D'Agostino D Levy AM Belanger H Silbershatz WB Kannel (1998) ArticleTitlePrediction of coronary heart disease using risk factor categories Circulation 97 1837–1847 Occurrence Handle9603539 Occurrence Handle1:STN:280:DyaK1c3msVOjsA%3D%3D

    PubMed  CAS  Google Scholar 

  3. Y Matsushima H Kawano Y Koide T Baba G Toda S Seto K Yano (2004) ArticleTitleRelationship of carotid intima-media thickness, pulse wave velocity, and ankle brachial index to the severity of coronary artery atherosclerosis Clin Cardiol 27 IssueID11 629–634 Occurrence Handle15562933 Occurrence Handle10.1002/clc.4960271110

    Article  PubMed  Google Scholar 

  4. P Poredos? (2002) ArticleTitleEndothelial dysfunction and cardiovascular disease Pathophysiol Haemost Thromb 32 274–277 Occurrence Handle13679656 Occurrence Handle10.1159/000073580 Occurrence Handle1:STN:280:DC%2BD3svlt1Sitw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  5. PC Simons A Algra ML Bots DE Grobbee Y van der Graaf (1999) ArticleTitleCommon carotid intima-media thickness and arterial stiffness. Indicators of cardiovascular risk in high-risk patients. The SMART study (second manifestations of arterial disease) Circulation 100 951–957 Occurrence Handle10468526 Occurrence Handle1:STN:280:DyaK1MzpvV2rsg%3D%3D

    PubMed  CAS  Google Scholar 

  6. P Poredos? (2004) ArticleTitleIntima-media thickness: indicator of cardiovascular risk and measure of the extent of atherosclerosis Vasc Med 9 46–54 Occurrence Handle15230488 Occurrence Handle10.1191/1358863x04vm514ra

    Article  PubMed  Google Scholar 

  7. A Cerne I Kranjec (2002) ArticleTitleAtherosclerotic burden in coronary and peripheral arteries in patients with first clinical manifestation of coronary artery disease Heart Vessels 16 IssueID6 217–26 Occurrence Handle12382030 Occurrence Handle10.1007/s003800200028

    Article  PubMed  Google Scholar 

  8. T Ishizu T Ishimitsu H Kamiya Y Seo N Moriyama K Obara S Watanabe I Yamaguchi (2002) ArticleTitleThe correlation of irregularities in carotid arterial intima-media thickness with coronary artery disease Heart Vessels 17 IssueID1 1–6 Occurrence Handle12434195 Occurrence Handle10.1007/s003800200035

    Article  PubMed  Google Scholar 

  9. AB Newman L Shemanski TA Manolio M Cushman M Mittelmark JF Polak NR Powe D Siscovick (1999) ArticleTitleAnkle-arm index as a predictor of cardiovascular disease and mortality in the Cardiovascular Health Study. The Cardiovascular Health Study Group Arterioscler Thromb Vasc Biol 19 IssueID3 538–545 Occurrence Handle10073955 Occurrence Handle1:STN:280:DyaK1M7nsVWjsQ%3D%3D

    PubMed  CAS  Google Scholar 

  10. GC Leng FG Fowkes AJ Lee J Dunbar E Housley CV Ruckley (1996) ArticleTitleUse of ankle brachial pressure index to predict cardiovascular events and death: a cohort study BMJ 313 IssueID7070 1440–1444 Occurrence Handle8973232 Occurrence Handle1:STN:280:ByiC38fmslA%3D

    PubMed  CAS  Google Scholar 

  11. ZJ Zheng AR Sharrett LE Chambless WD Rosamond FJ Nieto DS Sheps A Dobs GW Ewans G Heiss (1997) ArticleTitleAssociation of ankle-brachial index with clinical coronary heart disease, stroke and preclinical carotid and popliteal atherosclerosis: ARIC study Atherosclerosis 131 115–125 Occurrence Handle9180252 Occurrence Handle10.1016/S0021-9150(97)06089-9 Occurrence Handle1:CAS:528:DyaK2sXjvVSit7w%3D

    Article  PubMed  CAS  Google Scholar 

  12. CM Papamichael JP Lekakis KS Stamatelopoulos TG Papaioannou MK Alevizaki AT Cimponeriu JE Kanakakis A Papapanagiotou AT Kalofoutis S Stamatelopoulos (2000) ArticleTitleAnkle-brachial index as a predictor of the extent of coronary atherosclerosis and cardiovascular events in patients with coronary artery disease Am J Cardiol 86 615–618 Occurrence Handle10980210 Occurrence Handle10.1016/S0002-9149(00)01038-9 Occurrence Handle1:STN:280:DC%2BD3M%2FhtlOqsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  13. ME Safar BI Levy H Struijker-Boudier (2003) ArticleTitleCurrent perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular disease Circulation 107 2864–2869 Occurrence Handle12796414 Occurrence Handle10.1161/01.CIR.0000069826.36125.B4

    Article  PubMed  Google Scholar 

  14. T Matsuo K Iwade N Hirata M Yamashita H Ikegami N Tanaka M Aosaki H Kasanuki (2005) ArticleTitleImprovement of arterial stiffness by antioxidant and anti-inflammatory effects of short term statin therapy in patients with hypercholesterolemia Heart and Vessels 20 IssueID1 8–12 Occurrence Handle15700196 Occurrence Handle10.1007/s00380-004-0793-5

    Article  PubMed  Google Scholar 

  15. SS Franklin SA Khan ND Wong MG Larson D Levy (1999) ArticleTitleIs pulse pressure useful in predicting risk for coronary heart Disease? The Framingham Heart Study Circulation 100 IssueID4 354–60 Occurrence Handle10421594 Occurrence Handle1:STN:280:DyaK1MzltVOlsQ%3D%3D

    PubMed  CAS  Google Scholar 

  16. G Assmann P Cullen T Evers D Petzinna H Schulte (2005) ArticleTitleImportance of arterial pulse pressure as a predictor of a coronary heart disease risk in PROCAM Eur Heart J 26 IssueID20 2120–2126 Occurrence Handle16141262 Occurrence Handle10.1093/eurheartj/ehi467

    Article  PubMed  Google Scholar 

  17. G Assmann P Cullen H Schulte (2002) ArticleTitleSimple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Mal'nster (PROCAM) study Circulation 105 IssueID3 310–315 Occurrence Handle11804985 Occurrence Handle10.1161/hc0302.102575

    Article  PubMed  Google Scholar 

  18. P Pignoli E Tremoli A poli P Oreste R Paoletti (1986) ArticleTitleIntimal plus medial thickness of arterial wall: a direct measurement with ultrasound imaging Circulation 74 1399–1406 Occurrence Handle3536154 Occurrence Handle1:STN:280:BiiD2M3gslU%3D

    PubMed  CAS  Google Scholar 

  19. TJ Anderson (2003) ArticleTitleNitric oxide, atherosclerosis and the clinical relevance of endothelial dysfunction Heart Fail Rev 8 71–86 Occurrence Handle12652161 Occurrence Handle10.1023/A:1022199021949

    Article  PubMed  Google Scholar 

  20. PO Bonetti LO Lerman A Lerman (2003) ArticleTitleEndothelial dysfunction: a marker of atherosclerotic risk Arterioscler Thromb Vasc Biol 23 168–175 Occurrence Handle12588755 Occurrence Handle10.1161/01.ATV.0000051384.43104.FC Occurrence Handle1:CAS:528:DC%2BD3sXptFyrsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  21. JP Halcox WH Schenke G Zalos R Mincemoyer A Prasad MA Waclawiw KR Nour AA Quyyumi (2002) ArticleTitlePrognostic value of coronary vascular endothelial dysfunction Circulation 106 653–658 Occurrence Handle12163423 Occurrence Handle10.1161/01.CIR.0000025404.78001.D8

    Article  PubMed  Google Scholar 

  22. Y Koji H Tomiyama H Ichihashi T Nagae N Tanaka K Takazawa S Ishimaru A Yamashina (2004) ArticleTitleComparison of ankle-brachial pressure index and pulse wave velocity as markers of the presence of coronary artery disease in subjects with a high risk of atherosclerotic cardiovascular disease Am J Cardiol 94 868–872 Occurrence Handle15464667 Occurrence Handle10.1016/j.amjcard.2004.06.020

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Vascular Disease, University Medical Centre, Zaloška 2, 1000, Ljubljana, Slovenia

    Barbara Eržen, Mišo Šabovič, Miran Šebeštjen & Pavel Poredoš

Authors
  1. Barbara Eržen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mišo Šabovič
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Miran Šebeštjen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pavel Poredoš
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Barbara Eržen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Eržen, B., Šabovič, M., Šebeštjen, M. et al. Endothelial dysfunction, intima-media thickness, ankle-brachial pressure index, and pulse pressure in young post-myocardial infarction patients with various expressions of classical risk factors. Heart Vessels 22, 215–222 (2007). https://doi.org/10.1007/s00380-006-0958-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-006-0958-5

Key words

Search

Navigation