Arterial Stiffness Measured as Pulse Wave Velocity is Highly Correlated with Coronary Atherosclerosis in Asymptomatic Patients

Abstract

Aim: Carotid-femoral pulse wave velocity is a well-known predictor of all-cause and cardiovascular mortality. Few studies have evaluated the relationship between brachial-ankle pulse wave velocity (ba-PWV) and coronary artery disease. We conducted this study to elucidate the relationship between arterial stiffness measured by ba-PWV and coronary atherosclerosis.
Methods: An automatic waveform analyzer was used to measure the ba-PWV. Multidetector computed tomography coronary angiography was used to assess the coronary artery calcium (CAC) score and to detect coronary stenosis. A total of 654 patients, including 358 women and 296 men (mean age, 54.5±9.4 years), were recruited during the period March 2005 to June 2008.
Results: One hundred and twenty-seven patients (19.4%) had at least one stenotic coronary vessel. Mean ba-PWV and mean CAC scores were significantly higher in the stenotic group than in the normal control (15.94±3.07 m/s vs. 14.39±0.98 m/s; 293.1±435.9 vs. 29.8±110.8, respectively; both p < 0.001). The adjusted OR for coronary stenosis increased as ba-PWV increased (p for trend=0.0001). Using ba-PWV < 14.0 m/s as the reference group, we found that ba-PWV between 14.0-18.0 m/s and ba-PWV > 18.0 m/s were significantly associated with coronary stenosis (OR, 2.48; CI, 1.56-3.93 and OR, 3.16; CI, 1.68-5.95, respectively). The cutoff point at 15.64 m/s using the ROC curve showed a sensitivity of 64.5%, specificity of 65.6%, and an AUC of 0.662 in predicting coronary artery stenosis. Ba-PWV had an additional power for correlating coronary artery disease with the Framingham risk score.
Conclusions: Ba-PWV correlated well with coronary atherosclerosis. Lifestyle modification is an efficacious therapeutic intervention for preventing the progression of arterial stiffness. This non-invasive technique can assist in the early detection of cardiovascular disease and should be included in community screening programs.