Abstract
Background: Endothelial dysfunction is the early sign of cardiovascular diseases and assessed by the flow-mediated dilatation (FMD) of the brachial artery. In patients with insulin resistance, endothelial dysfunction is reduced and assessed by FMD. The work aimed to study the association between (homeostatic model assessment of the insulin resistance) and the brachial fractional flow dilatation (FFD) with the presence of coronary artery disease (CAD) in nondiabetic individuals, with or without insulin resistance. Patients and Methods: A total of 100 nondiabetic individuals were following up in the cardiology department and divided into (Group 1) 40 patients with insulin resistance (Group 2). Sixty patients without insulin resistance. FMD of the brachial artery was measured then the nitroglycerin-mediated dilatation (NMD). We calculated the fractional flow dilatation (FFD) as follow: NMD-FMD/NMD. Results: The predictive value of FFD for the detection of CAD in insulin resistance group with a cutoff value >0.465 (P < 0.0001), with a sensitivity of 89.2% and specificity of 92.3%. The predictive value of FFD is ≥0.575 (P = 0.001), with a sensitivity of 78.9% and specificity of 74.2% in the non-IR group. Conclusion: FFD is independent predictors for CAD, especially in insulin resistance subjects.
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