Arterial structure and function in patients with acute coronary syndrome after 1‑year treatment

INTRODUCTION    The modification of arterial stiffness and intima-media thickness (IMT) is controversial in patients with clinically significant atherosclerosis. OBJECTIVES    We evaluated the effects of 1‑year pharmacological therapy on arterial stiffness and IMT in survivors of non‑ST‑segment elevation myocardial infarction (NSTEMI) who were treated according to current clinical guidelines. PATIENTS AND METHODS    A total of 298 patients with NSTEMI (median age, 64 years; 85 women) were enrolled to this study. Local (carotid) arterial stiffness and IMT were measured noninvasively before discharge and after 12 months of contemporary pharmacological treatment according to current clinical guidelines. The study group was divided into patients with normal systolic blood pressure (BP) (<140 mm Hg) and those with increased systolic BP (≥140 mm Hg) at 12 months. The results were presented as median (25th-75th percentile). RESULTS    There were no significant changes in local arterial stiffness between patients with normal and those with increased systolic BP (8.9 m/s [7.9-10.9 m/s] vs 8.7 m/s [7.8-10.1 m/s] at baseline and 9.6 m/s [8.3-11.0 m/s] vs 10.4 m/s [9.1-12.4 m/s] at 12 months, P = 0.67 and P = 0.05, respectively); however, a significant reduction in IMT was found in both groups (777 μm [664-896 μm] vs 715 μm [619-841 μm] at baseline and 818 μm [720-962 μm] vs 760 μm [674-897 μm] at 12 months, P = 0.0003 and P = 0.001, respectively). Arterial stiffness and IMT were affected by age and mean BP; however, adjustment for these variables did not affect the obtained results in multivariate models. CONCLUSIONS    The 1‑year pharmacological treatment of patients after NSTEMI was associated with a significant reduction in IMT but had no effect on the properties of the arterial structure.