P7.01 CAROTID ATHEROSCLEROSIS AND ENDOTHELIAL DISFUNCTION IN YOUNG AND MIDDLE-AGED MEN WITH CORONARY ARTERY DISEASE

Abstract

Objective: To determine whether the structural status of carotid arteries and abnormal flow-mediated dilatation (FMD) in the brachial artery identify young and middle-aged men with coronary artery disease (CAD). Methods: A total of 78 men aged 28 to 50 (mean 43±5) years underwent carotid ultrasound and endothelial function measurements. Angiographically documented CAD was present in 49 patients. Those with arterial hypertension, diabetes mellitus or marked hypercholesterolemia (level of LDL cholesterol ≥4,9mmol/l) were excluded from the study. Results: Patients with CAD more often were smokers, had a history of premature CAD and low level of HDL cholesterol. The mean carotid intima-media thickness (IMT) was 0.88±0.23mm for patients with CAD and 0.76±0.18mm for patients without CAD (p=0.01). The presence of a carotid IMT≥0.9mm was not significantly differing in both groups. Carotid plaques were present in 45 (91.8%) patients with CAD and in 8 (27.6%) patients without CAD (p<0.001). Patients with CAD more often had multiple plaques (86.7% vs 13.8%, p<0.001). Mean brachial artery FMD was less in patients with CAD (4.5±2.8% vs 5.8±2.2%, p=0.03), but the occurrence of abnormal FMD was the same in both groups. Conclusion: The presence of carotid plaques in young and middle-aged men is associated with the risk of occurrence of CAD and may be considered as a more powerful surrogate marker for coronary atherosclerosis than the presence of impaired brachial artery FMD and increase in carotid IMT.