COMPARISON OF PERIPHERAL ENDOTHELIAL DYSFUNCTION AND INTIMAL MEDIA THICKNESS IN PATIENTS WITH SUSPECTED CORONARY-ARTERY DISEASE

Objective-Flow associated dilatation (FAD%) and intimal media thicknes s are established markers of early atherosclerosis. This study aimed t o compare the ability of the non-invasive measurements FAD% and intima l media thickness to predict coronary artery disease. Methods-FAD% and intimal media thickness were determined using high resolution ultraso und in 122 patients with clinically suspected coronary artery disease before coronary angiography. Results are given as mean (SD). Results-P atients with coronary artery disease had reduced FAD% compared with th ose with angiographically normal coronary vessels (3.7 (4.1) v 7.0 (3. 5)%, p < 0.001), whereas intimal media thickness tended to be increase d in patients with coronary artery disease (0.58 (0.35) v 0.47 (0.11)m m, p = 0.054). There was a negative correlation between FAD% and intim al media thickness (R = -0.317, p = 0.0004). Receiver operating charac teristic analysis showed that FAD% less than or equal to 4.5% predicte d coronary artery disease with a sensitivity of 0.71 (95% confidence i nterval 0.61 to 0.80) and a specificity of 0.81 (0.58 to 0.95). In con trast, intimal media thickness showed a positive correlation with the extent of coronary artery disease (number of vessels with a lesion gre ater than or equal to 50%) (R = 0.324, p = 0.0003), without a clear cu t off point. Conclusions-In patients with clinically suspected coronar y artery disease, FAD% discriminates between the presence or absence o f coronary artery disease, whereas intimal media thickness is associat ed more with the extent of coronary artery disease.