Intima-media thickness and flow-mediated dilatation in the diagnosis of coronary artery disease in perimenopausal women

INTRODUCTION: Noninvasive diagnosis of coronary artery disease (CAD) in perimenopausal women is a considerable challenge for the clinical practice. OBJECTIVES: The aim of the study was to investigate whether ultrasound examination of the endothelial function and arterial remodeling can be useful for CAD risk assessment in perimenopausal women. PATIENTS AND METHODS: The study involved 65 women with chest pain and positive stress test. Based on the results of coronary angiography, they were divided into 2 groups: a study group with coronary lesions (n = 32) and a control group without coronary lesions (n = 33). The mean age was 50.3 +/-3.2 years (study group: 50.3 +/-3.5 years; control group: 50.2 +/-3.0 years; P = 0.9). Atherosclerotic risk factors were analyzed in all patients. The ultrasound examination was used to assess early atherosclerotic remodeling of the artery by measuring the intima-media thickness (IMT) and endothelial dysfunction by measuring the flow-mediated dilatation (FMD). RESULTS: The IMT was significantly higher in the study group compared with controls (0.059 +/-0.01 mm vs. 0.049 +/-0.01 mm, respectively; P <0.001); FMD was significantly lower in the study group compared with controls (6.53 +/-0.98 vs. 7.89 +/-0.85, respectively; P <0.001). For IMT, the area under the receiver operating characteristic curve (AUROC) was 0.73 (95% confidence interval [CI] 0.6-0.85; P <0.001); therefore, this parameter cannot be used as a predictor of CAD. FMD with the AUROC of 0.85 (95% CI 0.76-0.94; P <0.001) had a good predictive value for CAD. CONCLUSIONS: Evaluation of IMT and FMD in perimenopausal women can be a useful noninvasive diagnostic tool for CAD risk assessment.