Investigating the Association of Relative Central Blood Pressure Indices and Severity of Coronary Artery Disease

Background: Central blood pressure is an important index in central hemodynamic stress and may be associated with an increased risk of cardiovascular diseases. Objectives: This study evaluated the central blood pressure indices in coronary artery disease (CAD) subjects and their association with the number of diseased vessels involved in CAD. Methods: A random sample of 300 Iranian subjects who underwent coronary angiography (mean age 58.08 ± 10.62 years) was studied. Coronary lesions were defined as luminal stenosis ≥ 50% and the number of diseased vessels and the central aortic pressure were taken. The probability of central blood pressure indices with the number of diseased vessels was also determined by using cut-off points, based on the sensitivity, specificity, positive predictive value, and negative predictive value. Results: The central blood pressure indices (fractional pulse pressure (FPP), systolic pressure (FSP), diastolic pressure (FDP) and FSP/FDP) were statistically significant in CAD patients with an increase in the number of diseased vessels (P < 0.001). There was a significant association between central blood pressure indices and CAD (P < 0.001) as well as with the increase in the number of diseased vessels (P < 0.001). Both odds ratio (11.84; 95% CI: 6.11 - 22.95; P < 0.001) and ROC analysis (AUC: 0.909; 95% CI: 0.870 - 0.939; P < 0.001) showed FSP as the strongest predictor of CAD. Furthermore, cut-off points of the FSP (≥ 1.373), FDP (≤ 0.811), FPP (≥ 0.559) and FSP/FDP (≥ 1.688) were determined for CAD for the first time based on 92% sensitivity, and 74% specificity. Conclusions: FDP, FSP, and FSP, in particular, could be the effective predictors of CAD in Iranian populations. Therefore, the quality of life may be improved by the management of central blood pressure and using CAD cut-off points.