Augmentation index is associated with coronary revascularization in patients with high Framingham risk scores: a hospital-based observational study.
BACKGROUND
This study analyzed PWAs in patients with high Framingham risk scores to determine whether PWA is predictive of coronary artery disease (CAD) severity and percutaneous coronary intervention (PCI) treatment.


METHODS
In total, 310 patients were screened due to suspected CAD; 78 were excluded due to PCI history (32), atrial fibrillation (11), or acute myocardial infarction (35). The augmentation index (AIx) was analyzed immediately before coronary angiography. PCI was performed in 73 (31.5 %) patients.


RESULTS
The mean AIx, adjusted by heart rate (AIx@75) was different for each clinical diagnosis in the PCI group (stable angina, 30.6 ± 7.7 %; silent ischemia, 30.2 ± 8.6 %; unstable angina, 38.5 ± 8.5 %; p = 0.026). The 10-year estimate of CVD risk, based on the Framingham heart score, was 25.3 ± 6.5 % and the mean AIx@75 was 31.6 ± 8.5 % in the PCI group, significantly higher than in the non-PCI group (18.8 ± 10.2 %, p < 0.001; 27.2 ± 9.0 %, p = 0.006, respectively). An inverse correlation was observed between the minimal luminal area and AIx@75 (rho = -0.559, p = 0.010, n = 20). In ROC curve analysis of multivariate logistic regression model, higher HDL, medication of hypertension, and higher body mass index were associated with non-PCI and higher AIx@75 was associated with PCI (area under the curve, 0.764; 95 % CI: 0.701 to 0.819, z = 8.005; p <0.001).


CONCLUSIONS
The AIx@75 seemed to reflect the clinical severity of CAD and was associated with PCI in patients with a high Framingham risk score.
Division of Cardiology, Department of Internal Medicine, School of Medicine, Jeju National University, #15, Aran 13gil, Jeju, 690-797, Korea. valgom@hanmail.net.
JoonHyouk
J
Choi
Division of Cardiology, Department of Internal Medicine, School of Medicine, Jeju National University, #15, Aran 13gil, Jeju, 690-797, Korea. ttoromom@jejunu.ac.kr.
Song-Yi
SY
Kim
Division of Cardiology, Department of Internal Medicine, School of Medicine, Jeju National University, #15, Aran 13gil, Jeju, 690-797, Korea. sejjoo@jejunu.ac.kr.
Seung-Jae
SJ
Joo
Division of Cardiology, Department of Internal Medicine, School of Medicine, Jeju National University, #15, Aran 13gil, Jeju, 690-797, Korea. ls1988@medimail.co.kr.
Ki-Seok
KS
Kim
D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D063177:Pulse Wave Analysis; D056910:Republic of Korea; D012307:Risk Factors; D012720:Severity of Illness Index