2D.04

Abstract

Objective: To evaluate arterial stiffness in young patients from a very high CV risk country presented with a first acute ST-elevated myocardial infarction and to analyse association between increased arterial stiffness and the severity of coronary artery disease. Design and method: Consecutive patients with age less than 45 years admitted in our department for a first acute STEMI between January 2013 – January 2014 were enrolled in the study after signing a written informed consent. All patients underwent primary PCI at inclusion for evaluation of coronary artery disease (normal, univascular lesions, bivascular lesions, trivascular lesions). Arterial stiffness was assessed by aortic pulse wave velocity, aortic augmentation index, and central aortic systolic blood pressure measurements by an oscillometric device. Association between traditional CV risk factors and the severity of CAD was assessed by bivariate correlation analysis with adjustments for major confounders. Results: Mean age of the study sample was 40.13 ± 4.36years. Gender distribution showed a male preponderance (86,7%). The majority of the patients (25 cases, 83,33%) had significant atherosclerotic lesions on the MI related artery. More, bivascular and trivascular atherosclerotic lesions were recorded eight cases (13.33%) each, while the majority has univascular lesions (18 cases, 60%).. Mean (range) PWVao values were: PWVao 9.10 ± 1.77m/s (7–14.4m/s), 23.33% of cases having PWVao > 10m/s. Increased PWVao values were correlated with: smoking [rs2 = 0,343; p < 0,0001], increased BMI [rs2 = 0.190; p = 0.001], presence of hypercholesterolemia [rs = rs2 = 0.192; p = 0.001], presence of hypertriglyceridemia rs2 = 0.285; p < 0,0001], hyperglycaemia [rs = rs2 = 0.194; p = 0.001] and the severity of coronary atherosclerotic lesions [rs2 = 0,270; p = 0,003]. Conclusions: Results of our study shows that in young STEMI patients increased arterial stiffness is correlated with both atherosclerotic risk factors (such as smoking, dislipidemic, BMI) and with the severity of coronary artery disease. Although the majority of the patients had significant atherosclerotic lesions, only a minority has PWVao > 10m/s suggesting that the actual cut-off value of this parameter could be lower in this group of patients.