title: Central pulse pressure amplification is associated with more extensive and severe coronary artery disease.
abstract: OBJECTIVE
  We investigate the association between noninvasively determined central pulse waveform characteristics and the extent and severity of coronary artery disease (CAD) in patients undergoing coronary angiography with the clinical diagnosis of CAD.
  
  
  METHODS
  We included 145 consecutive patients with stable angina pectoris (SAP), unstable angina pectoris (USAP), or acute myocardial infarction (AMI) who were decided to undergo coronary angiography. Gensini and SYNTAX scores were calculated. Noninvasive PWA was performed with the SphygmoCor system.
  
  
  RESULTS
  Dividing the patients into tertiles according to augmentation index (AIx), more patients had significant CAD with higher Gensini and SYNTAX scores and lower myocardial blush grade (MBG) (p < 0.001 for all) in the third tertile. The AIx value to predict the presence of moderate to severe CAD as determined by SYNTAX score ≥ 23 was 24.45% (ROC analysis AUC: 0.96; sensitivity 88%, specificity: 93%, 95% CI: 0.93-0.99, p < 0.001). AIx was significantly correlated with Gensini and SYNTAX scores in SAP, USAP, and AMI patients after adjusting for age, gender, height, heart rate, hypertension, and diabetes.
  
  
  CONCLUSIONS
  Increased AIx is associated with the presence and severity of CAD, and it may be used in selected patients during cardiovascular evaluation in outpatient settings for risk stratification prior to coronary angiography.
authors.affiliation: Ufuk University Faculty of Medicine, Department of Cardiology , Ankara , Turkey.
authors.forename: Asli
authors.initials: A
authors.lastname: Tanindi
authors.forename: Aycan Fahri
authors.initials: AF
authors.lastname: Erkan
authors.forename: Aslihan
authors.initials: A
authors.lastname: Alhan
authors.forename: Hasan Fehmi
authors.initials: HF
authors.lastname: Töre
mesh_terms: D000368:Aged; D001794:Blood Pressure; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012372:ROC Curve; D012720:Severity of Illness Index
keywords: Augmentation index; SYNTAX score; extent and severity of coronary artery disease; pulse waveform analysis