Aortic pulse pressure and aortic pulsatility are associated with angiographic coronary artery disease in women.

BACKGROUND

Studies indicated that both aortic pulse pressure (PP) and aortic pulsatility are independently associated with angiographic coronary artery disease (CAD). However, most of these studies included a majority of male subjects, and women were underrepresented.

OBJECTIVE

We investigated the relation of aortic PP and aortic pulsatility derived from invasively measured ascending aortic pressure waveform and presence of angiographic CAD in women undergoing diagnostic coronary angiography.

METHODS AND RESULTS

From September 2003 to April 2004, 262 unselected female subjects undergoing first cardiac catheterization were consecutively included in the study. Systolic, diastolic and mean pressure waveforms of the ascending aorta were measured during cardiac catheterization with a fluid-filled system. Aortic pulsatility was estimated as the ratio of aortic PP to mean pressure. Angiographic CAD was detected in 175 (67%) patients. In multiple-adjusted logistic regression, both aortic PP and aortic pulsatility were significantly associated with the presence of CAD (for a 10-mmHg increase in PP: odds ratio [OR] = 1.3, 95% confidence interval [CI] = 1.1-1.76; for a 0.1 increase in aortic pulsatility: OR = 1.8, 95% CI = 1.3-2.4). When patients were divided into tertiles according to the level of aortic pulsatility, it was noted that multiple-adjusted OR of presence CAD was 2.2 (95% CI = 1.1-4.4) for the middle tertile of the aortic pulsatility level and 5.9 (95% CI = 2.7-12.8) for the highest tertile of the aortic pulsatility level compared with the lowest tertile.

CONCLUSION

In female subjects referred to coronary angiography, ascending aorta PP and aortic pulsatility are significantly associated with the presence of angiographic CAD and these associations are independent of age and other cardiovascular risk factors.