OS 13-03 HIGH UPSTROKE TIME OF ARTERIAL PULSE WAVE IS AN INDEPENDENT PREDICTOR FOR THE PRESENCE OF CORONARY ARTERY DISEASE.

OBJECTIVE: Pulse wave velocity is a non-invasive method that is useful not only for estimating arterial stiffness but also screening cardiovascular events in the general population. Upstroke time (UT) and % mean artery pressure (% MAP) are novel, adjunctive indices for arterial stiffness that are derived from morphology analysis of the pulse wave during brachial-ankle pulse wave velocity (baPWV) measurement. Several studies have shown the association between UT and coronary artery calcification score as assessed by multi-detector computed tomography (MDCT). However, there are no studies examining relationship between these markers and CAD as assessed by coronary angiography (CAG), the current gold standard for the diagnosis of CAD. The aim of this study was to determine the association between the indices for arterial stiffness such as UT and % MAP, and the presence of CAD as assessed by CAG.

DESIGN AND METHOD: We enrolled 98 patients who underwent both baPWV measurement and elective CAG for suspected CAD. Significant coronary artery disease(sCAD) was defined as having at least one stenotic lesion over 50%. Using univariate and multivariate logistic regression analysis, we evaluated the contribution of UT and % MAP for the presence of sCAD, and determined if they served as independent, incremental risks for sCAD.

RESULTS: In univariate logistic regression analysis, UT and % MAP were associated with sCAD (UT: Odds Ratio(OR) 1.23[95% Confidence Interval (95% CI) 1.00-1.50], p = 0.015; % MAP: OR 0.81[95% CI 0.68-0.96], p = 0.018), whereas baPWV was not (OR 1.03[95% CI 0.91-1.16], p = 0.587). In multivariate analysis, only UT remained significant after adjusting traditional risk factors and other potential confounders (OR 1.29 [95% CI 1.02-1.64]; p = 0.036).

CONCLUSIONS: Among indices for arterial pulse waves, only UT serves as independent, incremental risk for the presence of significant CAD.