Background: In those without symptoms of coronary artery disease (CAD), the incidence of
coronary events is still high. The aim of this study was to evaluate whether flow mediated
dilatation (FMD) is a useful tool in identifying those with CAD in who are under 45 years of age.
Methods and results: Seventy five men below 45 years of age, hospitalized in order to
perform elective coronary angiography, were enrolled into the study. Based on coronary angiography
findings, they were divided into two groups: study group (Group A, n = 55) with
obstructive coronary lesions and the control group (Group B, n = 20) without significant
lesions in coronary arteries. In all subjects atherosclerosis risk factors were analyzed. Endothelial
dysfunction was assessed in ultrasound via FMD. FMD was significantly lower in the
study group than in the control group (3.92 ± 1.1 vs 6.51 ± 1.1, p < 0.001). FMD, as well as
age, diabetes and positive family history, appeared to be statistically significant CAD risk
factors. AUROC for FMD was 0.957 (p < 0.001), meaning this model had an almost complete
ability to predict the presence of CAD. AUROC for CAD diagnosis on the basis of significant
clinical parameters was 0.992 (p < 0.001), also representing almost complete ability of this model
to identify asymptomatic subjects with CAD risk.
Conclusions: The evaluation of endothelial function by the use of FMD in the population of
men below 45 years of age with diabetes and positive family history can help in identifying
subjects at high risk of coronary artery disease. (Cardiol J 2010; 17, 3: 288-292