Key result
Aortic velocity propagation ≤ 78 cm/s strongly predicted the presence of coronary artery disease with 86.4% sensitivity, 84.6% specificity, and an AUC of 0.948.
Why the study?
Arterial stiffness is clinically relevant but neglected and not routinely used to evaluate atherosclerosis, prompting an evaluation of aortic velocity propagation, FHS, and QRISK3 for predicting CAD presence and severity.
Do aortic velocity propagation (AVP), FHS, and QRISK3 scores predict the presence and severity of CAD in Asian patients?
Cross-Sectional (n=250)
No
Do aortic velocity propagation (AVP), FHS, and QRISK3 scores predict the presence and severity of CAD in Asian patients?
Odds Ratio: 0.98 (95% CI 0.91–1)
p-value: p=0.001
Aortic velocity propagation is a simple, non-invasive echocardiographic parameter that strongly predicts the presence and severity of CAD, offering a useful bedside tool for risk stratification.
AVP with FRS/QRISK3 may aid CAD prediction; hypothesis-generating and needs prospective validation before adoption.
Introduction: Despite having clinical relevance, arterial stiffness is neglected and not routinely used parameter for evaluation of atherosclerosis. This study aimed to investigate the predictive role of simple non-invasive echocardiographic index of aortic stiffness aortic velocity propagation (AVP), Framingham risk score (FHS) and QRISK3 score for presence and severity of CAD. Methods: This cross-sectional comparative study included 250 patients who required conventional coronary angiogram for stable CAD. The relationship of AVP, FHS and QRISK3 score with CAD were evaluated using spearman’s correlation, logistic regression analysis and ROC curve. Results: On logistic regression analysis, AVP, FHS and QRISK3 were found significant predictors for the presence and severity of CAD. Inverse correlation between AVP and presence of CAD, number of coronary vessels involved and severity of CAD was observed with P=0.001. AVP value≤78 cm/s predicted presence of CAD with 86.4% sensitivity and 84.6% specificity (P≤0.0001, AUC=0.948) and≤39 cm/s predicted severe CAD (Syntax score>22) with 66.7% sensitivity and 97.9% specificity (P≤0.0001, AUC=0.868). FHS value>10 predicted the presence of CAD with a sensitivity of 33.9% and specificity of 91 % (P=0.01, AUC=0.644). QRISK3value>13.4 predicted presence of CAD with 57.1% sensitivity and 87% specificity (P≤0.0001, AUC=0.788). Conclusion: Arterial stiffness parameter AVP is inversely associated with the presence and severity of CAD. AVP and QRISK3 score may be used as a simple bedside tool for risk stratification of patients suspected of having atherosclerotic CAD.
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Vyas et al. (2022) conducted a cross-sectional in Coronary artery disease (n=250). Aortic velocity propagation (AVP) vs. Non-CAD group was evaluated on Presence of coronary artery disease (OR 0.980, 95% CI 0.91-1.00, p=0.001). Aortic velocity propagation ≤ 78 cm/s strongly predicted the presence of coronary artery disease with 86.4% sensitivity, 84.6% specificity, and an AUC of 0.948.
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