Korean Circ J.  2010 May;40(5):224-229. 10.4070/kcj.2010.40.5.224.

The Value of Brachial-Ankle Pulse Wave Velocity as a Predictor of Coronary Artery Disease in High-Risk Patients

• Seo WW
• Chang HJ
• Cho I
• Yoon YY
• Suh JW
• Kim KI
• Cho YS
• Youn TJ
• Chae IH
• Choi DJ
• Kim CH
• Chun EJ
• Choi SI

• KMID: 1456366
• DOI: http://doi.org/10.4070/kcj.2010.40.5.224

Abstract

BACKGROUND AND OBJECTIVES
Arterial stiffness has been known as an independent contributory factor for coronary artery disease (CAD). Brachial-ankle pulse wave velocity (baPWV) is widely used as a simple noninvasive measure of arterial stiffness. The aim of our study was to test whether baPWV had predictive value for CAD in the subset of patients with high pretest probability.
SUBJECTS AND METHODS
We enrolled 174 consecutive patients who were referred for evaluation of suspected CAD, and who underwent both baPWV measurement and computed tomography (CT) for coronary artery calcium scoring (CACS) as part of a diagnostic work-up. Subsequently, 160 of those patients underwent invasive coronary angiography. The CAD indices consisted of 1) CACS, 2) modified Gensini scoring system, and 3) presence of obstructive CAD and 4) multi-vessel obstructive CAD.
RESULTS
baPWV correlated with CACS (r=0.25, p=0.001), but not with modified Gensini scoring (r=0.10, p=0.19). However, after adjustment for factors influencing PWV, baPWV no longer correlated with CACS (r=0.14, p=0.14). By receiver operating characteristic (ROC) curve analysis, baPWV was neither a sensitive nor specific index for predicting the presence of obstructive CAD or multi-vessel obstructive CAD (sensitivity: 53% and 59%; specificity: 50% and 55%, respectively).
CONCLUSION
Our findings demonstrated that baPWV is associated with CACS, however, this may be primarily attributed to common risk factors, such as age. Furthermore, baPWV may be of limited value in identifying patients at risk for CAD.

Keyword

Coronary artery disease; Compliance

MeSH Terms

Calcium
Compliance
Coronary Angiography
Coronary Artery Disease
Coronary Vessels
Humans
Pulse Wave Analysis
Risk Factors
ROC Curve
Vascular Stiffness
Calcium

Figure

• 

  Fig. 1 ROC curve analysis of baPWV for obstructive CAD. A: for prediction of presence of obstructive coronary artery disease, baPWV cut-off value at 1,550 cm/s showed sensitivity 53%, specificity 50%, AUC 0.557. B: for prediction of multi-vessel obstructive CAD, 1,593 cm/s showed sensitivity 59%, specificity 55%, AUC 0.590. ROC: receiver operating characteristic, baPWV: brachial-ankle pulse wave velocity, CAD: coronary artery disease, AUC: area under curve.

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