Relation of arterial stiffness assessed by brachial-ankle pulse wave velocity to complexity of coronary artery disease.
BACKGROUND
The progression of atherosclerosis leads to increased arterial stiffness. The present study used brachial-ankle pulse wave velocity (baPWV) to evaluate the connection between arterial stiffness in patients with chest pain and the presence and extent of coronary artery disease (CAD).


METHODS
On a retrospective basis, we analyzed the data of 703 consecutive patients who had undergone baPWV and an elective coronary angiogram for suspected CAD, between June 2010 and July 2012, at a single cardiovascular center.


RESULTS
The baPWV was one of the statistically meaningful predictors of significant CAD (diameter of stenosis >50%) in addition to diabetes and dyslipidemia in a multivariate analysis. When the extent of CAD was classified into nonsignificant or significant CAD (ie, 1-, 2- and 3-vessel disease), there was a significant difference in baPWV between the significant and nonsignificant CAD groups, but there was no difference in baPWV among the 3 significant CAD groups. Linear regression analyses showed that baPWV was significantly associated with the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score. The cutoff value of baPWV at 1735 cm/s had a sensitivity of 55.6%, specificity of 62.4%, and area under receiver operating characteristic curve of 0.612 in predicting CAD.


CONCLUSIONS
Arterial stiffness as determined by baPWV is associated independently with significant CAD in patients with angina. Arterial stiffness is related to CAD severity as assessed by the SYNTAX score. As a result, increased arterial stiffness assessed by baPWV is associated with the severity and presence of CAD.
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi; Department of Internal Medicine, Chang Gung University of Science and Technology, Chiayi County; Department of Internal Medicine, Chang Gung University, Taoyuan County, Taiwan.
Chang-Min
CM
Chung
Teng-Yao
TY
Yang
Yu-Sheng
YS
Lin
Shih-Tai
ST
Chang
Ju-Feng
JF
Hsiao
Kuo-Li
KL
Pan
Shih-Jung
SJ
Jang
Jen-Te
JT
Hsu
D000368:Aged; D055109:Ankle Brachial Index / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis / Q000379:methods*; D012189:Retrospective Studies; D059289:Vascular Stiffness / Q000502:physiology*