title: Brachial-ankle pulse wave velocity for the prediction of the presence and severity of coronary artery disease.
abstract: The predictability of brachial-ankle pulse wave velocity (baPWV) for the presence and severity of coronary artery disease (CAD) was investigated by measuring baPWV in 501 subjects scheduled for coronary angiography. Severity of CAD was measured using modified Gensini stenosis score (GSS) and classified as a vessel disease score (VDS) of 0-3. The presence of CAD was defined as diameter stenosis>50%. Subjects were grouped in tertile by level of baPWV (<14, 14-17,  >17 m/s). Subjects with CAD showed higher mean age, prevalence of men and diabetes, and systolic blood pressure. The prevalence of hypertension, use of antihypertensive medications and use of statin was not different. Subjects with CAD had higher baPWV than subjects without CAD (16.70 ± 3.46 versus 15.21 ± 3.19 m/s, p<0.001). Multiple linear regression analysis showed significant correlation of baPWV and modified GSS (p=0.0337). ANCOVA adjusted with age, gender, body mass index, presence of hypertension or diabetes, status of smoking, use of antihypertensive medications and risk of hypercholesterolemia showed a statistically significant association of baPWV with VDS (p<0.0001). Highest tertile of baPWV had a statistically significant effect on the severity of CAD from an ANCOVA model. The predictive power of highest tertile of baPWV for the presence of CAD was 3.600 [95% confidence interval (CI) 1.884-6.881, p<0.0001]. It is concluded that increased baPWV is a reliable predictor of the presence and severity of CAD, suggesting that baPWV>17 m/s may be a threshold value for the presence and severity of CAD.
authors.affiliation: Cardiovascular Center, Dongguk University Ilsan Hospital , Goyang , Republic of Korea .
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Moo-Yong
authors.initials: MY
authors.lastname: Rhee
authors.forename: Yong-Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Jun-Ho
authors.initials: JH
authors.lastname: Bae
authors.forename: Deuk-Young
authors.initials: DY
authors.lastname: Nah
authors.forename: Young-Kwon
authors.initials: YK
authors.lastname: Kim
authors.forename: Myoung-Mook
authors.initials: MM
authors.lastname: Lee
authors.forename: ChiYeon
authors.initials: C
authors.lastname: Lim
authors.forename: Chan-Joo
authors.initials: CJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000503:physiopathology; D055109:Ankle Brachial Index; D001794:Blood Pressure / Q000502:physiology; D001916:Brachial Artery / Q000503:physiopathology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D016909:Tibial Arteries / Q000503:physiopathology*
keywords: Pulse wave velocity; brachial-ankle pulse wave velocity; coronary angiography; coronary artery disease; modified Gensini stenosis score