Presence and extent of coronary artery disease and relationship between the aortic pulse wave velocity

Introduction and objective: It was shown in several studies that arterial stiffness is a predictor of hypertension, stroke, cardiovascular events and mortality. Pulse wave velocity (PWV) , one of the parameters showing arterial stiffness, was studied in many different patient groups. Even though there are few publications about relationship between extent of coronary artery disease and pulse wave velocity, clinical studies indicate a relation between pulse wave velocity and presence of coronary artery disease. Purpose of this study is to demonstrate a relationship between pulse wave velocity and presence and extent of coronary artery disease.Material and methods: 103 consecutive patients for whom coronary angiography planned because of symptoms and risk profiles were included in this study. 69 were male and the patients were between 33-73 years old (mean age: 55,2±8,5). Aortic PWV?s of all pateints were calculated by using SphygmoCor (AtCor medical Instruments) tonometry. Coronary angiography was performed for all patients due to coronary artery disease suspicion. Coronary artery disease was diagnosed in 59 of 103 patients, 44 patients were free of the disease. Patients were subdivided into two groups as patients with coronary artery disease and patients without coronary artery disease. Gensini score showing the severity of coronary artery disease was calculated in patients with coronary artery disease.Findings: Mean PWV of all patients was 7.0 ± 2,6. Mean PWV of patients with coronary artery disease was 8.6 ± 2.0 while it was 5,0 ± 1.8 in patients without coronary artery disease. The difference was statistically significant.( p < 0,001) while there was a significant relationship between presence of coronary artery disease and PWV, there was a strong correlation between PWV and the extent of coronary artery disease. Sensitivity and specificity of PWV in determination of coronary artery disease were calculated by ROC curve. When the cut off value of PWV was taken as 7.3, the senstivity was 83.1% and specificity was 86.4 %. For the same cut off value the positive predicive value of PWV in determination of coronary artery disease was 89% and negative predictive value was 79.1 % .Results: Several non invasive techniques are being used to detect coronary artery disease. These tecniques are required to be easily applicable and to have a high positive predictive values. Remarkable achievements are carried out in predicting coronary artery disease but stil no tests are effective enough to predict coronary artery disease in all patients. So always there?s a need for additional methods in screening and diagnosis. By this view PWV calculated by using tonometry in daily practice represents a valuable and non invasive methodKey Words: Coronary artery disease, pulse wave velocity