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Endothelial Dysfunction, Increased Arterial Stiffness, and Cardiovascular Risk Prediction in Patients With Coronary

Tatsuya Maruhashi1, Junko Soga1, Noritaka Fujimura1

  • 1Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Journal of the American Heart Association
|July 15, 2018
PubMed

Insights

Vascular function tests, including flow-mediated vasodilation (FMD) and brachial-ankle pulse wave velocity (baPWV), predict cardiovascular events in coronary artery disease patients. Combining FMD and baPWV enhances cardiovascular risk stratification.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Clinical Cardiology

Background:

  • The clinical utility of vascular function tests for managing patients with coronary artery disease (CAD) remains incompletely understood.
  • Assessing endothelial function and arterial stiffness is crucial for cardiovascular risk prediction.

Purpose of the Study:

  • To evaluate the predictive value of flow-mediated vasodilation (FMD) and brachial-ankle pulse wave velocity (baPWV) for future cardiovascular events in patients with established CAD.
  • To determine if combining FMD and baPWV improves cardiovascular risk stratification.

Main Methods:

  • A prospective, multicenter observational study involving 462 patients with CAD.
  • Measurement of FMD and baPWV in all participants.
  • Follow-up for primary outcomes: coronary events and a composite of coronary events, stroke, heart failure, and sudden death.

Main Results:

  • Higher FMD (≥7.1%) was significantly associated with a lower risk of both primary outcomes (HR 0.27-0.32).
  • Higher baPWV (≥1731 cm/s) was significantly associated with a higher risk of both primary outcomes (HR 1.86-2.19).
  • Stratification by combined FMD and baPWV levels revealed stepwise increases in risk for cardiovascular events.

Conclusions:

  • Both FMD and baPWV are significant predictors of cardiovascular events in patients with coronary artery disease.
  • The combined assessment of FMD and baPWV offers enhanced cardiovascular risk stratification beyond individual measures.
Abstract

Keywords:
arterial stiffnesscoronary artery diseaseendothelial functionflow‐induced dilationpulse wave velocity

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