The Timing of the Reflected Wave in the Ascending Aortic Pressure Predicts Restenosis after Coronary Stent Placement

It has been reported that the reflection waveform in the ascending aortic pressure is associated with systemic arterial stiffness. Stiffening of the aortic walls leads to a decrease in coronary perfusion and an increase in restenosis rate. The purpose of this study was to evaluate whether the reflection waveform in the ascending aortic pressure could be used to predict restenosis after percutaneous coronary stenting. One hundred and three patients who underwent percutaneous coronary stenting were enrolled in this study. We measured the inflection time and augmentation index (AIx) to determine the reflection waveform in the ascending aortic pressure at angioplasty. We then prospectively investigated the effect of inflection time and AIx in relation to the subsequent risk of restenosis after coronary stenting. After adjustments for age, gender, smoking habits, hypertension, type 2 diabetes, hypercholesterolemia, stent size, and heart rate, the odds ratio of restenosis in inflection time was 4.62 (95% confidence interval (CI), 1.39 to 15.4) for the lowest tertile of the inflection time level compared with the highest tertile level. As for AIx, the odds ratio of restenosis was 6.96 (95% CI, 1.93 to 25.1) for the highest tertile of the AIx level compared with the lowest tertile level. Inflection time and AIx are related to restenosis after percutaneous coronary stenting.