Endothelial dysfunction in patients with coronary artery disease in tertiary level teaching hospital

Abstract

Introduction: Endothelial Dysfunction is a pathological condition characterized by reduction of bioavailability of vasodilators, in particular, nitric oxide whereas endothelium-derived contracting factors are increased resulting in an impairment of endothelium- dependent vasodilation. ED can be assessed by Brachial Artery Flow Mediated Dilatation (BAFMD). The study is to determine the prevalence of endothelial dysfunction in patients with coronary artery disease.

Methods: A total of 150 adult patients above 18 years both male and female diagnosed as CAD both stable and acute were enrolled. All patients were undergone ultrasound assessment of brachial artery diameter. Brachial artery flow mediated dilatation (BAFMD) was calculated as percentage increase in diameter from the baseline and after sphygmomanometer cuff inflation. BAFMD <10% was considered abnormal, signifying ED.

Results: Overall, the prevalence of ED determined by abnormal flow mediated dilatation of brachial artery (FMD<10%) in patients with CAD was found to be 66%. The prevalence of ED in patients with acute CAD and stable CAD was found to have 62.7% and 68.7% respectively. Eight risk factors analyzed were male sex, diabetes mellitus, hypertension, smoking, family history of CAD, age, hypercholesterolemia and low high density lipoprotein (HDL). When correlating the cardiovascular risk factors with ED, diabetes mellitus (p=0.031), smoking (p=0.026), and age >45yrs in male and >55yrs in female (p=0.013) was found to be statistically significant on univariate analysis by logistic regression. When undergoing multivariate analysis, age (p= 0.012) and smoking (p= 0 .024) were significantly associated with ED.

Conclusion: Overall the prevalence of ED in patients with CAD was found to be 66%. The prevalence of ED in patients with acute CAD and stable CAD was found to have 62.7% and 68.7% respectively.