Key result
Achilles tendon thickness predicts ~171% higher odds of multivessel disease in ACS patients without FH.
Why the study?
Achilles tendon thickness is associated with CAD severity in familial hypercholesterolemia, but its relevance in non-familial hypercholesterolemia remains unclear.
Does Achilles tendon thickness correlate with coronary artery disease severity in patients with acute coronary syndrome without familial hypercholesterolemia?
Observational (n=194)
Does Achilles tendon thickness correlate with coronary artery disease severity in patients with acute coronary syndrome without familial hypercholesterolemia?
Ultrasonography-measured Achilles tendon thickness is significantly associated with coronary artery disease severity and multivessel disease in patients with acute coronary syndrome without familial hypercholesterolemia.
May support noninvasive CAD severity assessment in ACS; hypothesis-generating and should not yet change practice.
AIM: Achilles tendon xanthomas are a characteristic feature of familial hypercholesterolemia (FH). Achilles tendon thickness (ATT) has been associated with the severity of coronary artery disease (CAD) in FH. However, its relevance in non-FH remains unclear. Therefore, we assessed the relationship between ATT and CAD severity in patients with acute coronary syndrome (ACS) without FH. METHODS: A total of 194 patients (mean age: 69.1±11.9 years) with ACS without FH were retrospectively investigated and divided into two groups: single-vessel disease (SVD) or multivessel disease (MVD). ATT was measured using ultrasonography (US-ATT) and radiography (Xp-ATT). The association between ATT and CAD severity was evaluated. RESULTS: Of the total, 107 patients (55.2%) had SVD, and 87 (44.8%) had MVD. Mean US-ATT and Xp-ATT values were 5.0±0.6 mm and 6.4±1.2 mm, respectively. ATT was significantly greater in the MVD group than in the SVD group (US-ATT: 5.2 mm vs. 4.8 mm, p＜0.01; Xp-ATT: 6.6 mm vs. 6.1 mm, p = 0.01) and correlated with the SYNTAX score (US-ATT: r = 0.30, p＜0.01; Xp-ATT: r = 0.19, p = 0.02). Multivariable analysis identified US-ATT as an independent predictor of MVD (odds ratio: 2.71; 95% confidence interval: 1.46-5.01; p＜0.01). CONCLUSION: In patients with ACS without FH, ATT was significantly associated with CAD severity. This suggests that ATT, particularly US-ATT, may serve as a practical, non-invasive marker for cardiovascular risk stratification.
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Fujioka et al. (2025) conducted an observational in Acute coronary syndrome without familial hypercholesterolemia (n=194). Achilles tendon thickness (ATT) was evaluated on Multivessel disease (MVD) (OR 2.71, 95% CI 1.46-5.01, p=<0.01). In patients with ACS without familial hypercholesterolemia, ultrasound-measured Achilles tendon thickness was an independent predictor of multivessel disease (OR 2.71; 95% CI 1.46-5.01; p<0.01).
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