Department of Cardiology, Sejong General Hospital, Bucheon, Korea.
Korean Circ J. 2013 Apr;43(4):239-45. doi: 10.4070/kcj.2013.43.4.239. Epub 2013 Apr 30.
Arterial stiffness is well known as an important risk factor for cardiovascular disease. At our institution, we assessed the association between arterial stiffness, as determined by brachial ankle pulse wave velocity (baPWV), and the extent of coronary artery disease (CAD), as detected by conventional coronary angiography (CAG) in patients who visited the outpatient clinic for angina without any previous history of heart disease. In addition, we evaluated if the level of baPWV could predict the revascularization as a clinical outcome.
On a retrospective basis, we analyzed the data of 651 consecutive patients who had undergone baPWV and elective CAG for suspected CAD between June 2010 and July 2011, at a single cardiovascular center.
The baPWV was one of the statistically meaningful predictors of significant CAD (diameter of stenosis >50%) in addition to male gender, age, the level of high density lipoprotein-cholesterol, and hemoglobin A1c in multivariate analysis. However, baPWV was not the significant predictor of revascularization. When the extent of CAD was classified into following 4 groups; no significant CAD, 1-, 2- and 3-vessel disease, there was significant difference of baPWV between the significant and non-significant CAD group, but there was no difference of baPWV among the 3 significant CAD groups, although there was a trend toward the positive correlation.
Although baPWV was an independent predictor of significant CAD, it was neither associated significantly with the extent of CAD nor with the risk of revascularization. Therefore, baPWV has a limited value for portending the severity of CAD in patients with chest pain.
动脉僵硬度作为心血管疾病的一个重要危险因素已广为人知。在我们的机构中,我们评估了肱踝脉搏波速度(baPWV)所确定的动脉僵硬度与因心绞痛而在门诊就诊且无心脏病既往史的患者的冠状动脉疾病(CAD)严重程度之间的相关性,该评估是通过常规冠状动脉造影(CAG)进行的。此外,我们评估了 baPWV 水平是否可以预测作为临床结果的血运重建。
我们回顾性地分析了 2010 年 6 月至 2011 年 7 月在单一心血管中心因疑似 CAD 而接受 baPWV 和选择性 CAG 的 651 例连续患者的数据。
除了男性、年龄、高密度脂蛋白胆固醇水平和血红蛋白 A1c 之外,baPWV 也是多变量分析中 CAD 严重程度(狭窄程度> 50%)的有统计学意义的预测因子之一。然而,baPWV 并不是血运重建的显著预测因子。当 CAD 的严重程度分为无显著 CAD、1 支血管病变、2 支血管病变和 3 支血管病变这 4 个组时,在显著 CAD 组和非显著 CAD 组之间,baPWV 有显著差异,但在 3 个显著 CAD 组之间,baPWV 没有差异,尽管存在正相关的趋势。
尽管 baPWV 是 CAD 严重程度的独立预测因子,但它与 CAD 的严重程度或血运重建的风险无显著相关性。因此,baPWV 在预示胸痛患者 CAD 的严重程度方面价值有限。