期刊论文详细信息
BMC Cardiovascular Disorders
Augmentation index is associated with coronary revascularization in patients with high Framingham risk scores: a hospital-based observational study
Ki-Seok Kim1  Seung-Jae Joo1  Song-Yi Kim1  JoonHyouk Choi1 
[1] Division of Cardiology, Department of Internal Medicine, School of Medicine, Jeju National University, #15, Aran 13gil, Jeju 690-797, Korea
关键词: Waves;    Risk factors;    Coronary artery disease;    Atherosclerosis;   
Others  :  1228944
DOI  :  10.1186/s12872-015-0123-0
 received in 2014-12-27, accepted in 2015-10-02,  发布年份 2015
PDF
【 摘 要 】

Background

This study analyzed PWAs in patients with high Framingham risk scores to determine whether PWA is predictive of coronary artery disease (CAD) severity and percutaneous coronary intervention (PCI) treatment.

Methods

In total, 310 patients were screened due to suspected CAD; 78 were excluded due to PCI history (32), atrial fibrillation (11), or acute myocardial infarction (35). The augmentation index (AIx) was analyzed immediately before coronary angiography. PCI was performed in 73 (31.5 %) patients.

Results

The mean AIx, adjusted by heart rate (AIx@75) was different for each clinical diagnosis in the PCI group (stable angina, 30.6 ± 7.7 %; silent ischemia, 30.2 ± 8.6 %; unstable angina, 38.5 ± 8.5 %; p = 0.026). The 10-year estimate of CVD risk, based on the Framingham heart score, was 25.3 ± 6.5 % and the mean AIx@75 was 31.6 ± 8.5 % in the PCI group, significantly higher than in the non-PCI group (18.8 ± 10.2 %, p < 0.001; 27.2 ± 9.0 %, p = 0.006, respectively). An inverse correlation was observed between the minimal luminal area and AIx@75 (rho = −0.559, p = 0.010, n = 20). In ROC curve analysis of multivariate logistic regression model, higher HDL, medication of hypertension, and higher body mass index were associated with non-PCI and higher AIx@75 was associated with PCI (area under the curve, 0.764; 95 % CI: 0.701 to 0.819, z = 8.005; p <0.001).

Conclusions

The AIx@75 seemed to reflect the clinical severity of CAD and was associated with PCI in patients with a high Framingham risk score.

【 授权许可】

   
2015 Choi et al.

【 预 览 】
附件列表
Files Size Format View
20151021011110995.pdf 564KB PDF download
Fig. 2. 13KB Image download
Fig. 1. 28KB Image download
【 图 表 】

Fig. 1.

Fig. 2.

【 参考文献 】
  • [1]Franklin SS, Khan SA, Wong ND, Larson MG, Levy D: Is pulse pressure useful in predicting risk for coronary heart Disease? The Framingham heart study. Circulation 1999, 100:354-360.
  • [2]Borghi C, Dormi A, Ambrosioni E, Gaddi A: Relative role of systolic, diastolic and pulse pressure as risk factors for cardiovascular events in the Brisighella Heart Study. J Hypertens 2002, 20:1737-1742.
  • [3]Domanski M, Norman J, Wolz M, Mitchell G, Pfeffer M: Cardiovascular risk assessment using pulse pressure in the first national health and nutrition examination survey (NHANES I). Hypertension 2001, 38:793-797.
  • [4]Staessen JA, Gasowski J, Wang JG, Thijs L, Den Hond E, Boissel JP, et al.: Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet 2000, 355:865-872.
  • [5]O'Rourke MF, Mancia G: Arterial stiffness. J Hypertens 1999, 17:1-4.
  • [6]Hayashi T, Nakayama Y, Tsumura K, Yoshimaru K, Ueda H: Reflection in the arterial system and the risk of coronary heart disease. Am J Hypertens 2002, 15:405-409.
  • [7]Nichols WW, Singh BM: Augmentation index as a measure of peripheral vascular disease state. Curr Opin Cardiol 2002, 17:543-551.
  • [8]Weber T, Auer J, O'Rourke MF, Kvas E, Lassnig E, Berent R, et al.: Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation 2004, 109:184-189.
  • [9]Weber T, O'Rourke MF, Ammer M, Kvas E, Punzengruber C, Eber B: Arterial stiffness and arterial wave reflections are associated with systolic and diastolic function in patients with normal ejection fraction. Am J Hypertens 2008, 21:1194-1202.
  • [10]Liu J, Hong Y, D'Agostino RB Sr, Wu Z, Wang W, Sun J, et al.: Predictive value for the Chinese population of the Framingham CHD risk assessment tool compared with the Chinese Multi-Provincial Cohort Study. JAMA 2004, 291:2591-2599.
  • [11]D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al.: General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008, 117:743-753.
  • [12]Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, et al.: ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2012, 2013(127):e663-828.
  • [13]Kwon JE, Mintz GS, Kim SW, Oh MS, Min YJ, Kim HK, et al.: Relationship between coronary artery plaque composition by virtual histology intravascular ultrasound analysis and brachial-ankle pulse wave velocity in patients with coronary artery disease. Coron Artery Dis 2011, 22:565-569.
  • [14]Nichols WW, O'Rourke MF. Pressure Pulse Waveform Analysis. In: McDonald's Blood Flow in Arteries: Theroretical, Experimental and Clinical Principles, 5th edition. Edited by Nichols WW, O'Rourke MR. London, UK: Arnold; 2004:463-502
  • [15]Weber T, O'Rourke MF, Lassnig E, Porodko M, Ammer M, Rammer M, et al.: Pulse waveform characteristics predict cardiovascular events and mortality in patients undergoing coronary angiography. J Hypertens 2010, 28:797-805.
  • [16]Nurnberger J, Keflioglu-Scheiber A, Opazo Saez AM, Wenzel RR, Philipp T, Schafers RF: Augmentation index is associated with cardiovascular risk. J Hypertens 2002, 20:2407-2414.
  • [17]Patvardhan E, Heffernan KS, Ruan J, Hession M, Warner P, Karas RH, et al.: Augmentation index derived from peripheral arterial tonometry correlates with cardiovascular risk factors. Cardiol Res Pract 2011, 2011:253758.
  • [18]Cameron JD, McGrath BP, Dart AM: Use of radial artery applanation tonometry and a generalized transfer function to determine aortic pressure augmentation in subjects with treated hypertension. J Am Coll Cardiol 1998, 32:1214-1220.
  • [19]Recio-Rodriguez JI, Gomez-Marcos MA, Patino Alonso MC, Martin-Cantera C, Ibañez-Jalon E, Melguizo-Bejar A, et al.: Association between smoking status and the parameters of vascular structure and function in adults: results from the EVIDENT study. BMC Cardiovasc Disord 2013, 13:109. BioMed Central Full Text
  • [20]Kelly R, Hayward C, Avolio A, O'Rourke M: Noninvasive determination of age-related changes in the human arterial pulse. Circulation 1989, 80:1652-1659.
  • [21]D'Ascenzo F, Barbero U, Cerrato E, Lipinski MJ, Omedè P, Montefusco A, et al.: Accuracy of intravascular ultrasound and optical coherence tomography in identifying functionally significant coronary stenosis according to vessel diameter: A meta-analysis of 2,581 patients and 2,807 lesions. Am Heart J 2015, 169:663-73.
  文献评价指标  
  下载次数:38次 浏览次数:15次