title: Arterial stiffness measured as pulse wave velocity is highly correlated with coronary atherosclerosis in asymptomatic patients.
abstract: OBJECTIVE
  Carotid-femoral pulse wave velocity is a well-known predictor of all-cause and cardiovascular mortality. Few studies have evaluated the relationship between brachial-ankle pulse wave velocity (ba-PWV) and coronary artery disease. We conducted this study to elucidate the relationship between arterial stiffness measured by ba-PWV and coronary atherosclerosis.
  
  
  METHODS
  An automatic waveform analyzer was used to measure the ba-PWV. Multidetector computed tomography coronary angiography was used to assess the coronary artery calcium (CAC) score and to detect coronary stenosis. A total of 654 patients, including 358 women and 296 men (mean age, 54.5 ± 9.4 years), were recruited during the period March 2005 to June 2008.
  
  
  RESULTS
  One hundred and twenty-seven patients (19.4%) had at least one stenotic coronary vessel. Mean ba-PWV and mean CAC scores were significantly higher in the stenotic group than in the normal control (15.94 ± 3.07 m/s vs. 14.39 ± 0.98 m/s; 293.1 ± 435.9 vs. 29.8 ± 110.8, respectively; both p < 0.001). The adjusted OR for coronary stenosis increased as ba-PWV increased (p for trend = 0.0001). Using ba-PWV < 14.0 m/s as the reference group, we found that ba-PWV between 14.0-18.0 m/s and ba-PWV > 18.0 m/s were significantly associated with coronary stenosis (OR, 2.48; CI, 1.56-3.93 and OR, 3.16; CI, 1.68-5.95, respectively). The cutoff point at 15.64 m/s using the ROC curve showed a sensitivity of 64.5%, specificity of 65.6%, and an AUC of 0.662 in predicting coronary artery stenosis. Ba-PWV had an additional power for correlating coronary artery disease with the Framingham risk score.
  
  
  CONCLUSIONS
  Ba-PWV correlated well with coronary atherosclerosis. Lifestyle modification is an efficacious therapeutic intervention for preventing the progression of arterial stiffness. This non-invasive technique can assist in the early detection of cardiovascular disease and should be included in community screening programs.
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chiu-Shong
authors.initials: CS
authors.lastname: Liu
authors.forename: Chia-Ing
authors.initials: CI
authors.lastname: Li
authors.forename: Chuen-Ming
authors.initials: CM
authors.lastname: Shih
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Lin
authors.forename: Chih-Hsueh
authors.initials: CH
authors.lastname: Lin
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Lai
authors.forename: Tsai-Chung
authors.initials: TC
authors.lastname: Li
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality; D002339:Carotid Arteries / Q000473:pathology*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012372:ROC Curve; D012306:Risk; D012815:Signal Processing, Computer-Assisted; D014655:Vascular Resistance