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Cheloid is an excessive fibrous growth as a result of abnormal wound healing in response to skin injury. As postulated in “response to injury hypothesis”, atherosclerosis could also be an abnormal wound healing response to an endothelial injury. It is well known that endothelial dysfunction is an early finding of atherosclerosis. As a result, it could be hypothesized that endothelial dysfunction would be more prominent in patients having cheloid. The aim of this study was to assess the relationship between flow mediated diatation and cheloid formation.
Consecutive patients, who were admitted to the cardiology outpatient clinic with a history of coronary artery bypass grefting operation were evaluated. After application of exclusion criteria 69 patients enrolled into the study. 33 patients having cheloid formed cheloid group and 36 patients not having cheloid formed normal group. Endothelial function was measured with the help of flow mediated vasodilatation (FMD) of the brachial artery.
There is no signicant difference according to the demographical data, biochemical parameters, clinical parameters and number of grefts between cheloid and normal groups. Only fasting blood glucose was significantly higher in normal group (p=0.02) (Table 1). In cheloid group nomber of revascularization was s higher than normal group (p=0.025). Mean baseline brachial artery diameter was significantly lower in normal group than cheloid group (35.0±4.59, 37.7±4.03 respectively; p=0.012). No significant difference was found in mean hyperemia diameter of brachial artery between cheloid and normal groups. FMD was lower in cheloid group than normal group. (9.30±3.5, 18.68±8.2 respectively p=0.001) (Table 2).
This study showed that; endothalial function is significantly worsened in patients having cheloid after coronary artery bypass grefting operation than patients who did not. If we assume that endothelial function is an early finding of atherosclerosis we might say that atherosclerotic process would grow more agressive in patients havig cheloid than who do not. Hence, patients having cheloid might need more redo coronary artery bypass grefting or percutaneous coronary interventions.