Additional prognostic value of brachial-ankle pulse wave velocity to coronary computed tomography angiography in patients with suspected coronary artery disease. (January 2018)

• Record Type: Journal Article
• Authors: Hwang, In-Chang; Jin, Kwang Nam; Kim, Hack-Lyoung; Kim, You-Nui; Im, Moon-Sun; Lim, Woo-Hyun; Seo, Jae-Bin; Kim, Sang-Hyun; Zo, Joo-Hee; Kim, Myung-A
• Is Part Of: Atherosclerosis. Volume 268(2018)
• Page Start: 127
• Page End: 137
• Publication Date: 2018-01
• Subjects: Arterial stiffness -- Coronary artery disease -- Coronary CT angiography -- Prognosis; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2017.11.026
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Increased arterial stiffness is associated with a higher risk of future cardiovascular events. We aimed to investigate whether information about arterial stiffness provides additional prognostic value to coronary computed tomography angiography (CCTA) findings. Methods: A total of 523 consecutive patients (mean age, 58.0 ± 10.3 years; male, 60.6%) with suspected coronary artery disease (CAD), who underwent CCTA and brachial-ankle pulse wave velocity (baPWV) measurement within a month, were retrospectively analyzed. A composite of cardiovascular death, nonfatal myocardial infarction (MI), coronary revascularization, nonfatal stroke, and hospitalization for cardiovascular causes was assessed. Results: During a median 43.9 months of follow-up (interquartile range, 11.6–66.9 months), the composite endpoint occurred in 66 patients (3 cardiovascular deaths, 1 nonfatal MI, 35 coronary revascularizations, 16 nonfatal strokes, and 45 hospitalizations for cardiovascular causes). After adjustment for clinical risk factors and CCTA findings, higher baPWV was an independent prognostic factor for the composite endpoint (adjusted hazard ratio, 4.717; 95% confidence interval, 2.675–8.319; p < 0.001). The addition of baPWV to clinical risk factors and CCTA findings significantly improved the prediction of cardiovascular events (global χ 2 score, from 132 to 154; p = 0.005). Conclusions: Arterial stiffness provides additional prognostic information to CCTA findings in patients with suspected CAD. The baPWV can serve as a useful clinical tool for risk stratification in this population. Highlights: Brachial-ankle PWV is a reliable and non-invasive measure of arterial stiffness. Increased baPWV is an independent risk factor for cardiovascular events. baPWV adds prognostic information to CCTA findings in patients with suspected CAD. baPWV can be a useful tool for risk stratification among those with suspected CAD.