title: Combination of pulse wave velocity with clinical factors as a promising tool to predict major adverse cardiac events after percutaneous coronary intervention.
abstract: BACKGROUND
  The relationship between aortic stiffness and coronary artery disease has been proven. Logistic Clinical SYNTAX score (LogCSS), which combined the anatomical evaluation of coronary artery disease and three clinical factors (age, left ventricular ejection fraction, and creatinine clearance), showed improved predictive value for cardiovascular events in patients after percutaneous coronary intervention (PCI). The combination of pulse wave velocity (PWV) and clinical factors may show equivalent predictive value.
  
  
  METHODS
  Three hundred and seventy-six patients who were diagnosed with non-ST-segment elevation coronary syndrome (ACS) and showed at least one ≥50% angiographic stenosis in a major coronary artery were enrolled. The Clinical PWV score was calculated by assigning points to different levels of age, creatinine clearance, left ventricular ejection fraction, and carotid-femoral PWV (cfPWV). The points for cfPWV were determined based on the cutoff values of quintiles (model 1) or the relationship between cfPWV and SYNTAX scores (model 2). The predictive values of LogCSS and Clinical PWV score for 3-year major adverse cardiac events (MACE), which were defined as all-cause death, nonfatal myocardial infarction, and nonfatal target vessel revascularization, were analyzed in 298 patients undergoing PCI.
  
  
  RESULTS
  The Clinical PWV score based on model 2 demonstrated a similar predictive ability for 3-year MACE compared with LogCSS (AUC 0.72 vs. 0.75; p=0.11). The AUC of LogCSS was significantly higher than the AUC of Clinical PWV score based on model 1 (AUC=0.70, p=0.03). Compared with cfPWV in isolation (AUC=0.61), Clinical PWV score from model 2 showed significantly better predictive power (p=0.03).
  
  
  CONCLUSIONS
  Combination of PWV with age, creatinine clearance, and left ventricular ejection fraction appears to be a promising tool to predict MACE after PCI in patients with ACS.
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Bing-Wei
authors.initials: BW
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Zhi-Guang
authors.initials: ZG
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Xu
authors.initials: X
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. Electronic address: aimin_dang@yahoo.com.
authors.forename: Aimin
authors.initials: A
authors.lastname: Dang
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000367:Age Factors; D000368:Aged; D023921:Coronary Stenosis / Q000150:complications*; D003404:Creatinine / Q000032:analysis; D005260:Female; D006321:Heart / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D003404:Creatinine
keywords: Acute coronary syndrome; Percutaneous coronary intervention; Predictions; Pulse wave velocity; SYNTAX score