The effects of significant coronary stenosis and percutaneous coronary intervention on aortic stiffness.
OBJECTIVE
Although aortic stiffness (AS) is a strong predictor of cardiovascular events, its value is unknown in patients who have coronary stenosis and undergo percutaneous coronary intervention (PCI). Our hypothesis was that AS might provide additional information about coronary hemodynamic status. In this context, we investigated the effects of coronary stenosis and PCI on AS.


METHODS
The study included 107 patients undergoing coronary angiography. The patients were divided into three groups based on the angiographic results: 39 patients with significant lesions (≥50%) formed the 'critical group' and 38 patients with nonsignificant lesions (<50%) formed the 'noncritical group'. The control group (30 patients) had normal angiograms. Aortic stiffness was determined using the carotid-femoral aortic pulse wave velocity (PWV) method. All patients in the critical group underwent successful PCI and repeat PWV measurements.


RESULTS
All baseline characteristics were similar in the three groups except for the mean PWV, which was significantly higher (9.4±2.2 m/sec) in the critical group compared to the control group (5.7±1.1 m/sec) and the noncritical group (5.8±1.1 m/sec) (p<0.0001). The latter two groups had similar PWV values (p=0.6). After PCI, the mean PWV decreased significantly by 24.4% to 7.1±2.0 m/sec (p=0.002); however, it was still significantly higher than that of the control group (p<0.0001). In correlation analysis, PWV showed significant correlations with age (r=0.412, p=0.01), systolic blood pressure (r=0.342, p<0.01), and hemoglobin (r=-0.370, p=0.02). Multiple logistic regression analysis showed that PWV was a predictor for significant stenosis [Exp(B) 3.960, 95% CI 2.014-7.786].


CONCLUSIONS
Our findings suggest that significant coronary stenosis is associated with significantly increased AS and successful PCI improves AS to some extent.
Department of Cardiology, Medicine Faculty of Erciyes University, Kayseri, Turkey. nihatkalay@hotmail.com
Nihat
N
Kalay
Deniz
D
Elcik
Ali
A
Doğan
Tolga
T
Saka
Orhan
O
Doğdu
Fatih
F
Koç
Mikail
M
Yarlioğlueş
Mahmut
M
Akpek
Abdurrahman
A
Oğuzhan
Mehmet G
MG
Kaya
Idris
I
Ardiç
Ali
A
Ergin
D000368:Aged; D016022:Case-Control Studies; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness