title: Association between brachial-ankle pulse wave velocity and occult coronary artery disease detected by multi-detector computed tomography.
abstract: BACKGROUND
  Arterial stiffness, assessed by aortic pulse wave velocity (PWV), has been reported to predict cardiovascular morbidity and mortality. We assessed the association between arterial stiffness, as determined by PWV, and occult coronary artery disease (CAD), as detected by multi-detector computed tomography (MDCT), in asymptomatic individuals.
  
  
  METHODS
  We retrospectively enrolled 615 consecutive South Korean individuals who had undergone both brachial-ankle PWV (baPWV) and coronary CT angiography during general routine health evaluations at the Asan Medical Center in 2008.
  
  
  RESULTS
  We found that baPWV was positively correlated with age; body mass index; blood pressure; total cholesterol, homocysteine, and fasting blood glucose concentrations; and coronary artery calcium score. When we divided subjects into two groups according to the results of MDCT, we found that baPWV was significantly higher in subjects with (diameter of stenosis >50%) than without CAD (1573.2 ± 275.6 cm/s vs. 1409.6 ± 235.6 cm/s, p<0.01). The optimal baPWV cutoff value for detection of significant coronary arterial stenosis was 1426.0 cm/s, which had a sensitivity of 77% and a specificity of 63% (area under curve=0.71). After adjusting for age, smoking status, hypertension, diabetes, and dyslipidemia, the odds ratio for significant occult CAD was 3.30 (95% CI=1.47-7.41, p<0.01).
  
  
  CONCLUSIONS
  We found that baPWV was associated with risk factors for cardiovascular disease, including CACS, in asymptomatic individuals, and the optimal baPWV cutoff value for occult CAD detected by MDCT was 1426 cm/s. These findings suggest that baPWV may be a useful screening tool for predicting occult CAD.
authors.affiliation: Asan Heart Institute, University of Ulsan College of Medicine, Asan Medical Center, South Korea.
authors.forename: Hyo-Jung
authors.initials: HJ
authors.lastname: Nam
authors.forename: In Hyun
authors.initials: IH
authors.lastname: Jung
authors.forename: Jeongsoon
authors.initials: J
authors.lastname: Kim
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Jon
authors.initials: J
authors.lastname: Suh
authors.forename: Hee Sung
authors.initials: HS
authors.lastname: Kim
authors.forename: Hong Kyu
authors.initials: HK
authors.lastname: Kim
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Jung
authors.forename: Jun Won
authors.initials: JW
authors.lastname: Kang
authors.forename: Sihoon
authors.initials: S
authors.lastname: Lee
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index / Q000379:methods; D001783:Blood Flow Velocity / Q000502:physiology*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors