Comparison of ankle-brachial pressure index and pulse wave velocity as markers of the presence of coronary artery disease in subjects with a high risk of atherosclerotic cardiovascular disease.

Recently, a measurement device that can simultaneously measure the ankle-brachial pressure index (ABI) and brachial-ankle pulse wave velocity (PWV) has become available. The present study compares the applicability of ABI and PWV as markers for predicting the prevalence of coronary artery disease (CAD) in subjects with a high risk of atherosclerotic cardiovascular disease. The ABI and brachial-ankle PWV were measured in 472 consecutive subjects who subsequently underwent coronary angiography for diagnosis or exclusion of CAD. The prevalence of CAD in the lowest ABI quartile was higher than those in the other 3 ABI quartiles, whereas the prevalence in the lowest brachial-ankle PWV quartile was lower than those in the other 3 brachial-ankle PWV quartiles. A multivariate logistic regression analysis demonstrated that the lowest ABI quartile was a significant independent variable for the prevalence of CAD and that the lowest brachial-ankle PWV quartile was a significant independent variable for the absence of CAD in a population. Thus, a low ABI is an independent marker for an additive risk of CAD, whereas a low brachial-ankle PWV may be used as an independent marker for excluding the risk of CAD among subjects with a high risk of atherosclerotic cardiovascular disease.

[1]  D. Webb,et al.  Noninvasive assessment of arterial stiffness and risk of atherosclerotic events. , 2003, Arteriosclerosis, thrombosis, and vascular biology.

[2]  Shigeaki Hinohara,et al.  Influences of age and gender on results of noninvasive brachial-ankle pulse wave velocity measurement--a survey of 12517 subjects. , 2003, Atherosclerosis.

[3]  J. Staessen,et al.  Clinical applications of arterial stiffness; definitions and reference values. , 2002, American journal of hypertension.

[4]  P. Touboul,et al.  Echogenic Carotid Plaques Are Associated With Aortic Arterial Stiffness in Subjects With Subclinical Carotid Atherosclerosis , 2003, Hypertension.

[5]  Thomas Weber,et al.  Arterial Stiffness, Wave Reflections, and the Risk of Coronary Artery Disease , 2004, Circulation.

[6]  T. Pearson New Tools for Coronary Risk Assessment: What Are Their Advantages and Limitations? , 2002, Circulation.

[7]  P. Chowienczyk,et al.  Vasoactive Drugs Influence Aortic Augmentation Index Independently of Pulse-Wave Velocity in Healthy Men , 2001, Hypertension.

[8]  Daniel W. Jones,et al.  Ankle-Brachial Index and 7-Year Ischemic Stroke Incidence: The ARIC Study , 2001, Stroke.

[9]  A. Beckett,et al.  AKUFO AND IBARAPA. , 1965, Lancet.

[10]  Yuji Koide,et al.  High brachial-ankle pulse wave velocity is an independent predictor of the presence of coronary artery disease in men. , 2004, Hypertension research : official journal of the Japanese Society of Hypertension.

[11]  S M Grundy,et al.  Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: a statement for healthcare professionals from the American Heart Association and the American College of Cardiology. , 1999, Circulation.

[12]  H. Struijker‐Boudier,et al.  Current Perspectives on Arterial Stiffness and Pulse Pressure in Hypertension and Cardiovascular Diseases , 2003, Circulation.

[13]  Philip Greenland,et al.  Assessment of Cardiovascular Risk by Use of Multiple-Risk-Factor Assessment Equations , 1999 .

[14]  S. Feinstein,et al.  Noninvasive surrogate markers of atherosclerosis. , 2002, The American journal of cardiology.

[15]  A. Struthers,et al.  Pulse wave analysis and pulse wave velocity: a critical review of their strengths and weaknesses , 2003, Journal of hypertension.

[16]  P. Chowienczyk,et al.  Effects of Inhibition of Basal Nitric Oxide Synthesis on Carotid-Femoral Pulse Wave Velocity and Augmentation Index in Humans , 2003, Hypertension.

[17]  M. O'Rourke,et al.  Wave travel and reflection in the arterial system. , 1999, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[18]  A. Yamashina,et al.  Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. , 2002, Hypertension research : official journal of the Japanese Society of Hypertension.

[19]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[20]  J. Lekakis,et al.  Ankle-brachial index as a predictor of the extent of coronary atherosclerosis and cardiovascular events in patients with coronary artery disease. , 2000, The American journal of cardiology.