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Updated: Jun 24, 2026
A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Carotid intimal-media thickness and endothelial function in young patients with history of myocardial infarction
Insights
Young patients experiencing myocardial infarction (MI) show early signs of carotid atherosclerosis and endothelial dysfunction, indicating these vascular changes may serve as markers for coronary artery disease (CAD).
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Diagnostic Imaging
Background:
- Young patients with myocardial infarction (MI) often have underlying coronary artery disease (CAD).
- Early detection of atherosclerosis and endothelial dysfunction is crucial for risk stratification in these individuals.
Purpose of the Study:
- To assess the prevalence of carotid atherosclerosis and endothelial dysfunction in young MI patients.
- To determine if these vascular changes can serve as markers for coronary atherosclerosis.
Main Methods:
- Vascular echography was used to evaluate carotid intima-media thickness (IMT) and endothelial function.
- 45 young MI patients (mean age 42) and 45 healthy controls were compared.
Main Results:
- 30% of MI patients had normal IMT versus 66% of controls (P<0.0001).
- 34% of MI patients had increased IMT versus 24% of controls (P<0.0001).
- MI patients exhibited lower brachial artery flow-mediated reactivity (P<0.05), negatively correlated with IMT (P<0.001).
- Both carotid IMT and brachial artery reactivity independently correlated with CAD severity.
Conclusions:
- Structural (carotid atherosclerosis) and functional (endothelial dysfunction) vascular changes are prevalent in young individuals with a history of MI.
- These findings suggest carotid atherosclerosis and endothelial dysfunction are early indicators in young MI patients.
Aim:
The aim of the study was to evaluate the prevalence of carotid atherosclerosis and endothelial dysfunction in 45 young patients (38 mens and 7 females) with myocardial infarction (MI), age 29-45, mean age 42+/-3 years, to verify its possible role as a marker of coronary atherosclerosis.
Methods:
Vascular echography was performed to verify the presence of carotid atherosclerosis and/or endothelial dysfunction in 45 young patients with MI and in 45 healthy control subjects well matched for age and sex.
Results:
We observed a normal intima media thickness (IMT) only in 30% of patients with juvenile myocardial infarction (JMI) compared with 66% in the control group (P<0.0001) and 34% of patients showed an increased IMT compared with 24% of healthy subjects (P<0.0001). Compared with control subjects, patients with JMI had lower flow-mediated reactivity of the brachial arteries (P<0.05). There was a negative linear relationship between flow-mediated dilation and IMT (P<0.001). The severity of coronary artery disease (CAD) was correlated with increased IMT and with a lower flow-mediated dilation. Finally, multiple regression analysis, demonstrated that both brachial-artery reactivity and carotid IMT were significantly and independently correlated with severity of CAD.
Conclusions:
Structural (carotid atherosclerosis) and functional changes (endothelial dysfunction) were present at an early age in the arteries of persons with history of JMI.
