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Published on: August 17, 2022
Endothelial dysfunction in post-myocardial infarction patients with various expressions of risk factors
B Erzen1, M Sabovic, M Sebestjen
1Department of Vascular Diseases, University Medical Centre, Ljubljana, Slovenia. erzen_b@yahoo.com
Insights
Young male patients experiencing myocardial infarction (MI) often exhibit endothelial dysfunction (ED) regardless of classic risk factors. This suggests ED may precede atherosclerosis even without traditional risk indicators.
Area of Science:
- Cardiology
- Vascular Biology
- Internal Medicine
Background:
- Endothelial dysfunction (ED) is a known precursor to atherosclerosis.
- Its presence in myocardial infarction (MI) patients without classic risk factors remains unclear.
Purpose of the Study:
- To investigate the prevalence and extent of ED in young male MI patients with and without classic cardiovascular risk factors.
- To determine if ED occurs independently of traditional risk factors.
Main Methods:
- Ultrasound measurement of brachial artery endothelium-dependent vasodilation via reactive hyperemia test.
- Comparison of ED levels between MI patients (stratified by risk factors) and healthy controls.
Main Results:
- Significantly reduced endothelium-dependent vasodilation was observed in both MI patient groups compared to controls (p<.01).
- No significant difference in ED levels was found between MI patients with high versus low risk factors.
- ED was present even in the absence of classic cardiovascular risk factors.
Conclusions:
- Endothelial dysfunction is not solely associated with classic cardiovascular risk factors.
- ED may precede the development of atherosclerosis in individuals lacking traditional risk factors.
- These findings highlight potential novel pathways in cardiovascular disease development.
Abstract:
It has not been established yet whether patients who suffer myocardial infaction (MI) in the absence of classic risk factors also have endothelial dysfunction (ED), as has been shown for patients with risk factors, and if so, to what extent it is manifested. Young male patients in the stable phase after MI were included in the study. At the time of MI, 20 patients had high and 21 patients low expression of risk factors. The control group consisted of 35 healthy age-matched males. ED was estimated by ultrasound measurement of the endothelium-dependent dilation of the brachial artery, induced by the reactive hyperemia test. Compared to the control group, the level of endothelium-dependent vasodilation was significantly reduced in both groups of patients (controls: 9.1% +/- 5.6%; patients with high risk: 5.5% +/- 5.1%; patients with low risk: 5.6 +/- 3.5 %; ANOVA, p<.01). There was no difference between both groups of patients. These results showed that ED is not associated or due only to classic risk factors. It appears that ED may occur and precede development of atherosclerosis in the absence of classic risk factors. These novel findings can have important clinical implications.
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