We evaluated that brachial-ankle pulse wave velocity (baPWV) can be a risk stratification index to predict prognosis in patients with established CAD.Design and Method:
We recruited the patients undergoing emergent or elective PCI for stable angina or acute coronary syndrome from Chungbuk national university hospital cathlab database. The clinical outcomes were surveilled via chart reviews and telephone call.Results:
In total, 925 patients were enrolled (Male 670, 72.4%) with median follow-up of 524 days. The higher baPWV was defined as a median baPWV of 1730 cm s–1 or more. The patients were diagnosed as ST elevation MI (221, 23.0%), non ST elevation MI (221, 23.9%), unstable angina (294, 31.8%), stable angina (189, 20.4%). The composite end points of the study at follow-up of 12 months were cardiovascular death, nonfatal MI, and coronary revascularization. At a 12-month follow-up, we found 61 total ischemic events (higher PWV 7.9% vs normal PWV 5.8% (p = 0.211)), 18 cardiovascular deaths (2.0% vs 1.9% (p = 0.964)), 5 nonfatal MIs (0.8% vs 0.4% (p = 0.319)), 3 stent thrombosis (0.6% vs 0.3% (p = 0.313)) and 45 target-vessel revascularizations (5.9% vs 4.2% (p = 0.241)). In survival analysis, there was no significant difference between patients with higher baPWV and normal velocity. Multivariate analysis revealed that a higher baPWV was not significantly associated with poorer short-term prognosis (hazard ratio, 0.793; 95% confidence interval, 0.529–1.188) in established CAD patients.Conclusions:
baPWV, a marker for arterial stiffness, is not a risk stratification index for short-term prognosis in patients with established CAD patients. Routine use of PWV to predicting future cardiovascular events in patients with established CAD seems to be unnecessary.