Pulse wave velocity as a cardiovascular risk marker in patients with stable coronary heart disease

Abstract

Aim. To assess pulse wave velocity (PWV) as a potential marker of adverse prognosis, compared to conventional factors of cardiovascular risk. Material and methods. The study included 184 patients with myocardial infarction (MI). The MI diagnosis was confirmed by the presence of pathologic Q-wave on electrocardiogram and/or diagnostic elevation of cardiac biomarkers. Carotidfemoral PWV, reflecting the status of elastic arteries, was assessed using a standard method, with the automatic computerised system Colson (France). The follow-up period (from the start of the study to either the end-point development or the study end) varied from 1 to 60 months. The Kaplan-Meier method was used for the assessment of cumulative survival. Results. In patients with coronary artery disease (CHD), the five-year survival was 0,89 among those with PWV <10 m/s (8,3±0,13 m/s); 0,84 among those with PWV 10–12 m/s (11,1±0,32 m/s); and 0,44 among those with PWV ≥12 m/s (13,3±0,21 m/s). This difference was statistically significant. Moreover, among patients under 60 years, survival was 90,7%, while in their peers aged 60 years and older, it was only 78%. Among 184 participants, 54 had reduced left ventricular ejection fraction (LVEF) values (<40%). The five-year survival in those with LVEF>40% and <40% as 89,2% and 68,9%, respectively (the difference was statistically significant). In patients with type 2 diabetes mellitus, the survival was 69,6%, which was 19% lower than in patients with preserved systolic function. Conclusion. In CHD patients, increased PWV has a prognostic value similar to that for conventional cardiovascular risk factors and, therefore, can be regarded as an additional novel predictor of adverse prognosis.