Is Arterial Stiffness Useful in Differentiating Patients with Coronary Artery Disease from Risk Factor Only Patients?

Synn, Yi Chul; Bae, Jang Ho; Kim, Ki Young; Yoon, Hyun Ju; Koo, Hoon Sup; Kim, Jung Kyu; Hwang, Won Min; Lim, Dong Mi; Jeong, In Beom

Abstract

BACKGROUND AND OBJECTIVE
The endothelial function, carotid intima-media thickness (CIMT) and arterial stiffness are known as surrogates of atherosclerosis, but it is not clear whether these surrogates can discriminate patients with coronary artery disease (CAD) from those with risk factor. The intention was to compare these 3 surrogates in patients with CAD and those with risk factor only. SUCJECTS AND METHODS: Forty-three patients with CAD (mean age:58, 32 men), 18 age and sex matched healthy people (mean age:52, 9 men) and 16 patients (mean age:53, 12 men) with atherosclerosis risk factor only were enrolled. The endothelial function (flow-mediated brachial artery dilation, FMD) and CIMT were measured by high-resolution ultrasound and the arterial stiffness by an oscillometric method.
RESULTS
There was a significant difference between the CAD and risk factor groups (3.46+/-1.3% vs. 5.77+/-2.54%, p<0.05), but there was no significant difference between the risk factor and healthy groups (5.29+/-2.0% vs. 5.77+/-2.54%, p>0.05) in the measured FMD. The CIMT showed a significant difference between the CAD and healthy groups (0.89+/-0.14 mm vs. 0.78+/-0.07 mm, p<0.05), but there was no significant difference between the CAD and risk factor groups(0.89+/-0.14 mm vs. 0.83+/-0.12 mm, p>0.05). There were significant differences among all groups in relation to the arterial stiffness (CAD group:1524+/-289 cm/sec, risk group:1342+/-202 cm/sec, healthy group:1195+/-119 cm/sec, p<0.05). The arterial stiffness showed significant correlation with the FMD (r=-0.322, p=0.005) and CIMT (r=0.310, p=0.007).
CONCLUSION
Of the 3 surrogates, the arterial stiffness measurement showed the best reliability in differentiating the CAD from the risk factor only groups as well as from healthy subjects. This study suggests the arterial stiffness can be used as a novel noninvasive test for early diagnosis of CAD in patients at high risk of atherosclerosis.