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AMBULATORY ARTERIAL STIFFNESS INDEX IN THE SETTING OF ACUTE MYOCARDIAL INFARCTION

ASSOCIATION WITH THE TYPE OF INFARCTION AND CLINICAL CHARACTERISTICS

Koumelli, A.; Tsioufis, C.; Konstantinou, K.; Mantzouranis, E.; Kasiakogias, A.; Fragoulis, C.; Dimitriadis, K.; Tousoulis, D.

doi: 10.1097/01.hjh.0000571508.73994.f1
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Objective: The aim of the present study was to assess the vascular status as assessed by the ambulatory arterial stiffness index (AASI) in patients hospitalized for acute myocardial infarction (AMI).

Design and method: We studied 197 patients [78.9% male; mean age 62.44 years old; 68.5% hypertensives; 27.9% with diabetes mellitus (DM)] who were hospitalized because of ST-elevation MI (STEMI, 50.3%) and Non-ST–elevation MI (NSTEMI, 49.7%). All patients underwent baseline estimation of clinical and laboratory parameters during their hospitalization. Moreover, patients underwent 24-hour ambulatory blood pressure (BP) monitoring during the third day of their hospital stay. AASI was measured according to established methodology as 1- (slope of diastolic on systolic blood pressure (BP) during 24-h ambulatory BP monitoring).

Results: In univariate analysis, impaired AASI was significantly associated with NSTEMI (r = 0.195; p = 0.006), gender (r = 0.211; p = 0.003), age (r = 0.372; p < 0.001), history of DM (r = 0.236; p = 0.001), 24-h systolic BP (r = 0.419; p < 0.001) and low density lipoprotein (LDL-C) (r = 0.161; p = 0.025) but not body mass index (BMI), smoking and severity of coronary artery disease assessed by the number of affected main vessels. After multivariate analysis was conducted, AASI retained its significant association with the type of AMI independently of age, gender, HTN, DM and LDL-C (b = 0.143; p = 0.043).

Conclusions: In patients admitted for AMI there is a significant relationship between AASI and the type of MI. These findings suggest differential impact of hemodynamic load on the cardiovascular system in patients with STEMI and NSTEMI.

First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, GREECE

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