Park Hyun Woong, Kang Min Gyu, Kim Kyehwan, Koh Jin-Sin, Park Jeong Rang, Hwang Seok-Jae, Jeong Young-Hoon, Ahn Jong Hwa, Jang Jeong Yoon, Kwak Choong Hwan, Park Yongwhi, Hwang Jin-Yong
aDivision of Cardiology, Department of Internal Medicine, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju bDivision of Cardiology, Department of Internal Medicine, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
Coron Artery Dis. 2017 Dec;28(8):642-648. doi: 10.1097/MCA.0000000000000529.
Brachial-ankle pulse wave velocity (baPWV) measurement is a well-established modality for assessing arterial stiffness and predicting cardiovascular events. However, to our knowledge, its usefulness has not been clarified among patients with non-ST-elevation myocardial infarction (NSTEMI). This study assessed the prognostic value of baPWV in patients with NSTEMI.
Patients (n=411, mean age, 63.8±13.5 years, 75.2% men) with NSTEMI who underwent a percutaneous coronary intervention and baPWV measurement were recruited between January 2013 and December 2015. Cardiac mortality and major adverse cardiovascular events (MACE) including cardiac death, re-acute myocardial infarction, revascularization, heart failure, and stroke after discharge were analyzed. The mean follow-up duration was 350 days.
MACE and cardiac mortality occurred in 26 (6.3%) patients and 13 (3.1%) patients. Kaplan-Meier survival curves showed that MACE and cardiac mortality were significantly higher in patients with high baPWV (1708.0 cm/s). In multivariable Cox regression analysis, high baPWV (hazard ratio: 2.55; 95% confidence interval: 1.03-6.30, P=0.043) was an independent predictor of MACE even after adjusting for possible confounders.
Our findings indicate that baPWV was a strong independent prognostic factor of MACE in patients with NSTEMI. This suggests that baPWV can be a useful prognostic factor in the clinical setting for easier and less invasive prediction of MACE in patients with NSTEMI.
肱踝脉搏波速度（baPWV）测量是评估动脉僵硬度和预测心血管事件的一种成熟方法。然而，据我们所知，其在非ST段抬高型心肌梗死（NSTEMI）患者中的作用尚未明确。本研究评估了baPWV在NSTEMI患者中的预后价值。
选取2013年1月至2015年12月期间接受经皮冠状动脉介入治疗并测量baPWV的NSTEMI患者（n = 411，平均年龄63.8±13.5岁，男性占75.2%）。分析出院后心脏死亡率和主要不良心血管事件（MACE），包括心源性死亡、再发急性心肌梗死、血运重建、心力衰竭和卒中。平均随访时间为350天。
26例（6.3%）患者发生MACE，13例（3.1%）患者发生心脏死亡。Kaplan-Meier生存曲线显示，baPWV高（1708.0 cm/s）的患者MACE和心脏死亡率显著更高。在多变量Cox回归分析中，即使在调整了可能的混杂因素后，高baPWV（风险比：2.55；95%置信区间：1.03 - 6.30，P = 0.043）仍是MACE的独立预测因素。
我们的研究结果表明，baPWV是NSTEMI患者MACE的强有力独立预后因素。这表明baPWV在临床环境中可作为一个有用的预后因素，用于更简便且侵入性较小地预测NSTEMI患者的MACE。
