High Aortic Stiffness Assessed by Pulse Wave Velocity is an Independent Predictor of Coronary Artery Calcification and Stenosis in Suspected Coronary Artery Disease Patients

Background and Objectives:Aortic stiffness is an independent predictor of cardiovascular mortality and of all other causes in hypertensive patients. The object of this study was to investigate whether aortic stiffness, measured by pulse wave velocity (PWV), could be used as an independent predictor for detecting coronary artery atherosclerosis. Subjects and Methods:PWV was measured by an invasive method. All patients (n=187, M/F= 77/110) were suspected as having the coronary artery disease (CAD) and underwent coronary angiography. CAD was classified as that with or without calcification and stenosis and was classified by the calcification segments and stenotic vessel numbers. Results:Coronary artery calcification was significantly associated with diabetes mellitus (p<0.001), the waist/hip circumference ratio (p=0.012), hypertension (p=0.002), age (p<0.001) and PWV (p<0.001). Multiple logistic regression analysis revealed that coronary artery calcification was highly associated with age (OR=1.052, p=0.023) and PWV (OR=1.213, p<0.001). Significant coronary artery stenosis was associated with hypertension (p=0.002), diabetes mellitus (p=0.015), age (p=0.004), waist/hip circumference ratio (p=0.019), systolic blood pressure (p=0.007), pulse pressure (p=0.016), low density lipoprotein levels (p=0.004) and PWV (p<0.001). Multivariate analysis showed that PWV (OR=1.370, p<0.001) and low density lipoprotein levels (OR=1.022, p=0.006) were the best predictors of coronary artery stenosis. Patients with severe coronary atheosclerosis exhibited a greater increased aortic PWV. Conclusion:A high aortic PWV is an independent marker for coronary artery stenosis and calcification in suspected CAD patients. The aortic PWV could be used as an independent predictor for ischemic heart disease in patients with suspected CAD. (Korean Circulation J 2004;34(5):468-476)