Impacts of Atherosclerotic Coronary Risk Factors on Atherosclerotic Surrogates in Patients with Coronary Artery Disease

ABSTRACT

BACKGROUND AND OBJECTIVES: The carotid intima-media thickness, endothelial function and arterial stiffness have been shown to be parameters of atherosclerosis. We have performed this study to evaluate the impact of atherosclerotic coronary risk factors on several atherosclerotic parameters in patients with coronary artery disease. SUBJECTS AND METHODS: The study subjects consisted of one hundred and forty (140) consecutive patients (mean age 61 years, and 85 males), who demonstrated via coronary angiogram more than 50% stenosis in at least 1 major coronary artery. In an overnight fasting state, the carotid intima-media thickness (IMT), and endothelial function (flow-mediated brachial artery dilatation, FMD) were measured by high-resolution ultrasound, and arterial stiffness (pulse wave velocity, PWV) was measured by using a non-invasive pulse wave analyser. RESULTS: The hypertensive group showed more evidence of greater arterial stiffness (aorta; 8.5+/-1.0 m/s vs. 7.9+/-1.2 m/s, p=0.004, and greater stiffness of the artery of the lower extremity; 9.2+/-1.2 m/s vs. 8.7+/-1.3 m/s, p=0.010), which was measured by the pulse wave velocity, than that of the normotensive group. The carotid IMT and the endothelial function showed no significant differences between the two groups. Furthermore, these parameters did not show significant differences with other parameters such as diabetes mellitus, smoking, and hyperlipidemia. Multivariate analysis revealed that hypertension and systolic blood pressure were still the independent factors of arterial stiffness, but carotid IMT and endothelial function were not independent factors. CONCLUSION: Hypertension and systolic blood pressure are the independent factors of arterial stiffness in patients with coronary artery disease (CAD), but this study did not show that carotid IMT and endothelial function made a significant difference in arterial stiffness. However, in this study, other risk factors were not associated with the differences of these parameters.