Additional Value of Brachial-Ankle Pulse Wave Velocity to Single-Photon Emission Computed Tomography in the Diagnosis of Coronary Artery Disease - PubMed (original) (raw)

. 2017 Dec 1;24(12):1249-1257.

doi: 10.5551/jat.40071. Epub 2017 Aug 24.

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Additional Value of Brachial-Ankle Pulse Wave Velocity to Single-Photon Emission Computed Tomography in the Diagnosis of Coronary Artery Disease

Kyeongmin Jang et al. J Atheroscler Thromb. 2017.

Abstract

Aim: The aim of this study was to investigate whether information on arterial stiffness can improve the value of single-photon emission computed tomography (SPECT) in the detection of obstructive coronary artery disease (CAD).

Methods: A total of 233 patients (age: 62.2±10.8 years, 60.3% males) with detected ischemia on SPECT undergoing invasive coronary angiography (ICA) and brachial-ankle pulse wave velocity (baPWV) measurement within a month was retrospectively reviewed.

Results: Of the 233 patients, 190 (81.5%) had obstructive CAD (≥50% luminal stenosis). The difference in baPWV according to the presence of obstructive CAD was significant in patients in the mild ischemia group [summed stress score (SSS): 4-8] (1,770±364 cm versus 1,490±328 cm, p＜0.001) but not in the moderate (SSS: 9-13) or severe (SSS: ≥14) ischemia groups (p＞0.05 for each). Receiver operating characteristic curve analyses showed that the diagnostic value of baPWV for obstructive CAD was significant only in patients in the mild ischemia group (area under curve: 0.714; p=0.001) but not in the moderate or severe ischemia groups (p＞0.05 for each). Adding information on baPWV to SPECT results and clinical parameters significantly increased diagnostic accuracy in the detection of obstructive CAD in patients with mild ischemia (integrated discrimination improvement p=0.006) but not in those with moderate or severe ischemia on SPECT (p＞0.05 for each).

Conclusions: The results of this study suggest that baPWV may have additional value to SPECT for the detection of obstructive CAD, especially in patients with mild ischemia on SPECT.

Keywords: Arterial stiffness; Coronary artery disease; Pulse wave velocity; Single-photon emission computed tomography.

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Conflict of interest statement

The authors declare that there is no conflict of interest associated with this manuscript.

Figures

Fig. 1.

Fig. 1.

Values of SSS (A) and brachial-ankle PWV (B) according to the presence of obstructive CAD CAD, coronary artery disease.

Fig. 2.

Fig. 2.

Incidence of obstructive CAD according to the degree of ischemia on SPECT CAD, coronary artery disease; SPECT, single-photon emission computed tomography.

Fig. 3.

Fig. 3.

Values of brachial-ankle PWV according to groups based on the degree of ischemia on SPECT PWV, pulse wave velocity; SPECT, single-photon emission computed tomography.

Fig. 4.

Fig. 4.

ROC curve analysis showing additional value of baPWV to SSS in the diagnosis of obstructive CAD prob, probability; SSS, summed stress score; baPWV, brachial-ankle pulse wave velocity.

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