Increased arterial wave reflections predict severe cardiovascular events in patients undergoing percutaneous coronary interventions.
OBJECTIVE
Increased arterial wave reflections are associated with the presence and extent of coronary atherosclerosis and with cardiovascular mortality in selected populations. We prospectively evaluated their prognostic value in the short- and long-term following percutaneous coronary interventions (PCIs).


RESULTS
We non-invasively quantified wave reflections [expressed as augmentation index corrected for heart rate of 75 b.p.m. (AIx@75)] using applanation tonometry of the radial artery and a validated transfer function to obtain the corresponding aortic values in 262 patients undergoing PCI. During 2-year follow-up, 61 patients reached the primary endpoint [death, myocardial infarction (MI), and restenosis]. Increasing tertiles of Alx@75 were related to the rate of patients reaching the primary endpoint [15.2, 20 and 35.3%, respectively (P = 0.001)], as well as the secondary endpoints total mortality, myocardial infarction and death plus myocardial infarction (RR for the third vs. the first tertile 4.33, 3.25 and 3.46, respectively, P < 0.05). In a multivariable Cox-regression model, AIx@75 added prognostic value above and beyond clinical risk factors, angiographic variables, and medications (RR 1.8, 95%CI 1.18-2.76 per increasing AIx@75-tertile, P < 0.01).


CONCLUSIONS
Increased arterial wave reflections are independently associated with an increased risk for severe short- and long-term cardiovascular events in patients undergoing PCI.
Weber
Thomas
T
Cardiology Department, Klinikum of the Kreuzschwestern, Wels, Austria. thomas.weber@klinikum-wels.at
Auer
Johann
J
O'rourke
Michael F
MF
Kvas
Erich
E
Lassnig
Elisabeth
E
Lamm
Gudrun
G
Stark
Nina
N
Rammer
Martin
M
Eber
Bernd
B
D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary; D001794:Blood Pressure / Q000502:physiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D023921:Coronary Stenosis / Q000209:etiology; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors