Arterial stiffness predicts risk for long-term recurrence in patients with type 2 diabetes admitted for acute coronary event

Abstract

Objectives: to investigate the predictive value of arterial stiffness (AS) estimation for long-term recurrences in patients with type 2 diabetes (DM2) following acute coronary event. Patients and methods: prospective observational study involving 119 DM2 patients without history of coronary heart disease admitted with ST-segment elevation myocardial infarction (STEMI). Medical history, anthropometrics, smoking, HbA1c, lipid profile, troponine-I levels, and left ventricular ejection fraction (LVEF) were recorded. Carotid-femoral pulse wave velocity (cf-PWV) was measured 1 month after discharge. Patients were followed up for 36 months or to reach an end-point: cardiovascular death, acute coronary event, angioplasty or hospitalization for acute heart failure. To facilitate analysis, patients were divided into two groups according to cf-PWV, using the accepted cut-off value of 12 m/s. Results: overall, 34 patients had a recurrence. In Kaplan-Meier analysis patients with cf-PWV > 12 m/s had mean time-to-event 353 +/- 43 days compared to 505 +/- 115 days for patients with cf-PWV <= 12 m/s, log rank = 0.0252. In multivariate analysis factors independently associated with recurrence were age (66.53 +/- 6.87 vs. 61.54 +/- 10.77 years, p = 0.015), LVEF (41.66 +/- 8.21 vs. 47.58 +/- 8.11%, p = 0.001) and cf-PWV (13.94 +/- 2.91 vs. 12.35 +/- 2.77 m/s, p = 0.008). Conclusions: AS estimation in patients with DM2 after STEMI discriminate patients at higher risk for 3-year recurrence, and maybe valuable for distinguishing patients likely to require a more rigorous therapeutic intervention. (C) 2012 Elsevier Ireland Ltd. All rights reserved.