Impact of Aortic Stiffness on Cardiovascular Disease in Patients With Chest Pain. Assessment With Direct Intra-Arterial Measurement

Background: Aortic stiffness is an independent risk factor for cardiovascular (CV) events and mortality. However, there are few studies about the predictive role of aortic stiffness. We investigated the association between aortic pulse-wave velocity (aPWV), using direct intra-arterial measurement and future CV events, in patients with chest pain. Methods: Aortic pulse-wave velocity was measured through an aorto-femoral, fluid-filled system at baseline in 1004 patients with chest pain. Among these patients, 497 (237 male) were enrolled in the study. Aortic pulse-wave velocity was examined using tertiles. Tertiles were defined as follows: tertile 1, <9.20 m/sec; tertile 2, 9.21 to 12.49 m/sec; and tertile 3, >12.50 m/sec. The impact of aPWV on newly developed CV events, coronary artery disease (CAD), stroke, and congestive heart failure was evaluated. Results: A higher aPWV was associated with new CV events (odds ratio, 2.18 for tertile 3 v tertile 1; 95% confidence interval [CI], 1.32 to 3.60) and new CAD (odds ratio, 1.87 for tertile 3 v tertile 1; 95% CI, 1.10 to 3.18) in univariate analysis. In multivariate analysis, aPWV was associated with new CV events (odds ratio, 2.05 for tertile 3 v tertile 1; 95% CI, 1.18 to 3.55) and new CAD (odds ratio, 1.86 for tertile 3 v tertile 1; 95% CI, 1.03 to 3.35). Aortic pulse-wave velocity was not associated with either new stroke (P = .096) or congestive heart failure (P = .63). Conclusions: These results suggest that aPWV is an independent risk factor for future CV events and CAD in patients with chest pain.