Association of brachial-ankle pulse wave velocity with atherosclerosis and presence of coronary artery disease in older patients

Chang-Min Chung,1,2 Yu-Hsiang Tseng,3 Yu-Sheng Lin,3 Jen-Te Hsu,4 Po-Chang Wang31School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan County, 2Chang Gung University of Science and Technology, Chiayi County, 3Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, 4Department of Medicine, College of Medicine, Chang Gung University, Taoyuan County, TaiwanObjective: Brachial-ankle pulse wave velocity (baPWV) is a simple and reproducible measure of arterial stiffness and is extensively used to assess risk of cardiovascular disease in Asia. We examined whether baPWV was associated with coronary atherosclerosis and presence and extent of coronary artery disease (CAD) in older patients with chest pain.Methods: This cross-sectional study enrolled 370 consecutive patients >65 years old who underwent baPWV measurement and elective coronary angiogram for suspected CAD at a single cardiovascular center, between June 2013 and July 2014.Results: In addition to diabetes mellitus and body mass index, baPWV was one of the statistically meaningful predictors of significant CAD (diameter of stenosis >50%) in a multivariate analysis. When the extent of CAD was classified as nonsignificant or significant CAD (ie, one-, two-, and three-vessel disease), there was a significant difference in baPWV between the significant and nonsignificant CAD groups, but not between the three significant CAD groups. Multivariate linear regression analyses showed that the number of diseased vessels and baPWV were both significantly associated with the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score. The cutoff value of baPWV at 1,874 cm/s had a sensitivity of 60.1%, specificity of 70.8%, and area under receiver operating characteristic curve of 0.639 in predicting CAD.Conclusion: Arterial stiffness determined by baPWV was associated independently with CAD severity, as assessed by angiography and the SYNTAX score in older patients with chest pain. As a result, increased arterial stiffness assessed by baPWV is associated with the severity and presence of CAD in older patients.Keywords: brachial-ankle pulse wave velocity, arterial stiffness, coronary artery disease, SYNTAX scor