The value of brachial-ankle pulse wave velocity as a predictor of coronary artery disease in high-risk patients.
OBJECTIVE
Arterial stiffness has been known as an independent contributory factor for coronary artery disease (CAD). Brachial-ankle pulse wave velocity (baPWV) is widely used as a simple noninvasive measure of arterial stiffness. The aim of our study was to test whether baPWV had predictive value for CAD in the subset of patients with high pretest probability.


METHODS
We enrolled 174 consecutive patients who were referred for evaluation of suspected CAD, and who underwent both baPWV measurement and computed tomography (CT) for coronary artery calcium scoring (CACS) as part of a diagnostic work-up. Subsequently, 160 of those patients underwent invasive coronary angiography. The CAD indices consisted of 1) CACS, 2) modified Gensini scoring system, and 3) presence of obstructive CAD and 4) multi-vessel obstructive CAD.


RESULTS
baPWV correlated with CACS (r=0.25, p=0.001), but not with modified Gensini scoring (r=0.10, p=0.19). However, after adjustment for factors influencing PWV, baPWV no longer correlated with CACS (r=0.14, p=0.14). By receiver operating characteristic (ROC) curve analysis, baPWV was neither a sensitive nor specific index for predicting the presence of obstructive CAD or multi-vessel obstructive CAD (sensitivity: 53% and 59%; specificity: 50% and 55%, respectively).


CONCLUSIONS
Our findings demonstrated that baPWV is associated with CACS, however, this may be primarily attributed to common risk factors, such as age. Furthermore, baPWV may be of limited value in identifying patients at risk for CAD.
Seo
Won-Woo
WW
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Chang
Hyuk-Jae
HJ
Cho
Iksung
I
Yoon
Yeon-Yee
YY
Suh
Jung-Won
JW
Kim
Kwang-Il
KI
Cho
Yong-Seok
YS
Youn
Tae-Jin
TJ
Chae
In-Ho
IH
Choi
Dong-Ju
DJ
Kim
Cheol-Ho
CH
Chun
Eun-Ju
EJ
Choi
Sang-Il
SI