Key result
A relative difference in systolic blood pressure between arms of <1 mmHg combined with a brachial-ankle pulse wave velocity ≥1613 cm/s was associated with a higher rate of severe coronary stenosis.
Why the study?
Does the combination of the difference in blood pressure between arms and brachial-ankle pulse wave velocity predict the severity of coronary artery stenosis in patients undergoing coronary computed tomography angiography?
Observational (n=414)
Does the combination of the difference in blood pressure between arms and brachial-ankle pulse wave velocity predict the severity of coronary artery stenosis in patients undergoing coronary computed tomography angiography?
The combination of the relative difference in systolic blood pressure between arms and brachial-ankle pulse wave velocity may serve as an effective non-invasive tool to assess the severity of coronary artery disease.
May support non-invasive CAD stratification in CCTA patients; leaves open prospective validation before practice change.
BACKGROUND: A difference in systolic blood pressure (SBP) ≥10 mmHg between the arms is associated with an increased risk of coronary artery disease (CAD) and mortality in high-risk patients. METHODS AND RESULTS: Four hundred and fourteen patients were divided into three groups according to the percent most severe luminal narrowing of a coronary artery as diagnosed by coronary computed tomography angiography: no or mild coronary stenosis (0-49%), moderate stenosis (50-69%) and severe stenosis (≥70%) groups. The relative difference in SBP between arms in the severe group was significantly lower than those in the no or mild and moderate groups. The brachial-ankle pulse wave velocity (baPWV) significantly increased as the severity of coronary stenosis increased. We confirmed that severe coronary stenosis was independently associated with both the relative difference in SBP between arms and baPWV, in addition to age, gender, hypertension, dyslipidemia, diabetes mellitus and ankle-brachial index by a logistic regression analysis. The group with a relative difference in SBP between arms of <1 mmHg and baPWV ≥ 1613 cm/s showed a higher percentage of patients with severe coronary stenosis than groups that met neither or only one of these criteria. CONCLUSION: The combination of the relative difference in SBP between arms and baPWV may be a more effective approach for the non-invasive assessment of the severity of CAD.
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Miyase et al. (2015) conducted an observational in Coronary artery stenosis (n=414). Relative difference in systolic blood pressure between arms <1 mmHg and brachial-ankle pulse wave velocity ≥1613 cm/s vs. Patients meeting neither or only one of these criteria was evaluated on Severe coronary stenosis (≥70% luminal narrowing). A relative difference in systolic blood pressure between arms of <1 mmHg combined with a brachial-ankle pulse wave velocity ≥1613 cm/s was associated with a higher rate of severe coronary stenosis.
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