Elevated estimated pulse wave velocity (ePWV) was associated with a higher risk of target lesion revascularization with an adjusted hazard ratio of 1.46 per unit increase in ePWV (95% CI 1.18–1.79, P < 0.001) in elderly coronary artery disease patients after drug-coated balloon angioplasty.
Observational (n=423)
No
Does elevated estimated pulse wave velocity (ePWV) predict target lesion revascularization and MACE in elderly patients undergoing drug-coated balloon therapy for coronary artery disease?
Elevated estimated pulse wave velocity (≥10.91 m/s) is significantly associated with an increased risk of target lesion revascularization and MACE in elderly patients treated with drug-coated balloons for coronary artery disease.
Effect estimate: adjusted HR 1.46 per unit increase in ePWV (95% CI 95% CI 1.18–1.79)
p-value: p=<0.001
Introduction Drug-coated balloons (DCBs) constitute a vital therapeutic approach in the interventional management of coronary heart disease. Nevertheless, the risk factors for predicting target lesion revascularization (TLR) and major adverse cardiovascular events (MACE) specifically within the elderly population following DCB angioplasty remain incompletely understood. The study is to explore the relationship between estimated pulse wave velocity (ePWV) values and the risk of TLR and MACE in elderly patients undergoing DCB treatment, and to explore the optimal ePWV cutoff for clinical risk stratification. Methods A total of 423 participants were stratified into quartiles based on their ePWV values. Baseline characteristics were compared among these quartiles. The associations between ePWV and the risk of TLR and MACE were evaluated using Cox regression models, adjusted for multiple covariates. Kaplan–Meier analysis with the log-rank test was utilized to assess survival differences. The optimal ePWV cutoff for risk stratification was identified through maximally selected rank statistics. Subgroup analyses were performed to examine interactions between ePWV and clinical variables. Results Differences emerged across ePWV quartiles for age, TLR, and MACE (all P 0.05). Multivariate Cox regression revealed that elevated ePWV was associated with a higher risk of TLR (per unit increase: adjusted HR 1.46, 95% CI 1.18–1.79, P 0.001) and MACE. A dose-response relationship was observed, with the highest ePWV quartile exhibiting the highest risk compared to the lowest. Kaplan–Meier curves showed differences in survival across quartiles (TLR: log-rank P = 0.012; MACE: P 0.05). The optimal ePWV cutoff was identified at 10.91 m/s, differentiating high- and low-risk groups (log-rank P 0.05). Notably, subgroup analysis revealed sex-based interactions for both TLR and MACE, with the predictive value being consistently more pronounced in females. Conclusion Elevated ePWV was associated with a higher risk of TLR and MACE. An exploratory cutoff for ePWV at 10.91 m/s was identified, stratifying patients into distinct clinical risk groups.
Zhang et al. (Fri,) conducted a observational in Elderly patients (aged ≥65 years) with de novo coronary artery disease undergoing drug-coated balloon angioplasty (n=423). Drug-coated balloon angioplasty was evaluated on Freedom from clinically driven target lesion revascularization (TLR) defined as reintervention within 5 mm of original treated segment for >50% angiographic diameter stenosis with symptomatic worsening (adjusted HR 1.46 per unit increase in ePWV, 95% CI 95% CI 1.18–1.79, p=<0.001). Elevated estimated pulse wave velocity (ePWV) was associated with a higher risk of target lesion revascularization with an adjusted hazard ratio of 1.46 per unit increase in ePWV (95% CI 1.18–1.79, P < 0.001) in elderly coronary artery disease patients after drug-coated balloon angioplasty.