Value of combined central arterial stiffness index in predicting coronary artery disease

Objective To investigate the value of noninvasive detection of multiple arterial stiffness indexes in predicting coronary artery disease (CAD).Methods A total of 205 patients with risk factors for CAD underwent four noninvasive tests for arterial stiffness,including pulse wave velocity (PWV) ,large artery elasticity index(C1) ,small artery elasticity index(C2) ,pulse wave analysis (PWA) and carotid ultrasonography,and were divided into CAD group (n = 136) and control group (n = 69) by coronary angiography.Results The patients in CAD group were older,had more males and diabetes with higher creatinine,systolic blood pressure(SBP) and pulse pressure (PP) in baseline (P0.05) ,compared with patients in control group.The patients in CAD group had higher indexes of arterial stiffness including PWV,AP,central pulse pressure(CPP) ,C-IMT, C-Di (P 0.05).After adjusted for age,gender,height and heart rate,there was also significant difference in AP,CPP,CPP/PP and C-IMT (P 0.05) between the two groups.Multivariate regression analysis revealed that males,atherosclerotic plaques in common carotid artery ,CPP45 mm Hg,PWV increase(12 m/s or 9—12 m/s) were major independent risk factors for CAD. The logistic model was:y=In[P/(1-P)]= -4.112 + 1.798×male sex+1.105× atherosclerotic plaques in common carotid artery+1.000×CPP45 mm Hg +0.676 × PWV increase.Area under the ROC curve was 0.847.The optimal probability value for predicting CAD was 0.838.Conclusion Several arterial stiffness indexes were independent predictors for CAD.As a screening instrument, the logistic regression model might be useful in predicting the coronary lesion.