Prognostic value of brachial-ankle pulse wave velocity in patients with non-ST-elevation myocardial infarction.

Abstract

OBJECTIVE:

Brachial-ankle pulse wave velocity (baPWV) measurement is a well-established modality for assessing arterial stiffness and predicting cardiovascular events. However, to our knowledge, its usefulness has not been clarified among patients with non-ST-elevation myocardial infarction (NSTEMI). This study assessed the prognostic value of baPWV in patients with NSTEMI.

PATIENTS AND METHODS:

Patients (n=411, mean age, 63.8±13.5 years, 75.2% men) with NSTEMI who underwent a percutaneous coronary intervention and baPWV measurement were recruited between January 2013 and December 2015. Cardiac mortality and major adverse cardiovascular events (MACE) including cardiac death, re-acute myocardial infarction, revascularization, heart failure, and stroke after discharge were analyzed. The mean follow-up duration was 350 days.

RESULTS:

MACE and cardiac mortality occurred in 26 (6.3%) patients and 13 (3.1%) patients. Kaplan-Meier survival curves showed that MACE and cardiac mortality were significantly higher in patients with high baPWV (1708.0 cm/s). In multivariable Cox regression analysis, high baPWV (hazard ratio: 2.55; 95% confidence interval: 1.03-6.30, P=0.043) was an independent predictor of MACE even after adjusting for possible confounders.

CONCLUSION:

Our findings indicate that baPWV was a strong independent prognostic factor of MACE in patients with NSTEMI. This suggests that baPWV can be a useful prognostic factor in the clinical setting for easier and less invasive prediction of MACE in patients with NSTEMI.

• Authors: Hyun Woong Park, Min Gyu Kang, Kyehwan Kim, Jin-Sin Koh, Jeong Rang Park, Seok-Jae Hwang, Young-Hoon Jeong, Jong Hwa Ahn, Jeong Yoon Jang, Choong Hwan Kwak, Yongwhi Park, Jin-Yong Hwang
• Journal: Coronary artery disease (Coron Artery Dis) Vol. 28 Issue 8 Pg. 642-648 (Dec 2017) ISSN: 1473-5830 [Electronic] England
• PMID: 28692482 (Publication Type: Journal Article, Observational Study)

Topics

• Aged
• Aged, 80 and over
• Ankle Brachial Index
• Cause of Death
• Chi-Square Distribution
• Disease Progression
• Disease-Free Survival
• Female
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Multivariate Analysis
• Non-ST Elevated Myocardial Infarction (diagnosis, mortality, physiopathology, therapy)
• Percutaneous Coronary Intervention
• Predictive Value of Tests
• Proportional Hazards Models
• Prospective Studies
• Pulse Wave Analysis
• Recurrence
• Registries
• Reproducibility of Results
• Risk Factors
• Time Factors
• Treatment Outcome
• Vascular Stiffness