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Invasive Aortic Augmentation Index Could Predict the Adverse Events in Patients without Established Coronary Heart Disease

Tao Sun, Yu Tong Cheng, Su Wang, Ying Tao, Zhan Yong Zhao, Cheng Qian Yin, Dong Hua Zhang, Ji Huang, Zhao Li, Jing Mei Zhang and Zhi Zhong Li

Background: Previous studies had shown that an association between the arterial stiffness and cardiovascular events. Due to the invasive nature, fewer studies focus on invasive arterial stiffness in predicting adverse outcome. We examined the invasive predictive roles of pulsatile variables in patients without established coronary heart disease.

Method: Ascending aortic and radial artery waveforms were obtained during the angiography in 325 without severe coronary stenosis (<50%) from January, 2012 to October 2013 in An Zhen Hospital. These patients were followed for the cardiovascular adverse events during a median 2 years (inter-quartile range=0.6-3.2).

Results: During the followup, adverse events occurred in 36 (11%), after the adjustment of confounders, aortic augmentation index @75 remain the independent risks in predicting the clinical events. In Kaplan-Meier curve analysis, a 2 year cardiovascular event rate was 14% in patients with central aortic augmentation index @75≥0.15 vs. 4% in those with central aortic augmentation index @75<0.15 (Log Rank=0.045). The aortic augmentation index @75 (AUC 0.75) demonstrated a significant better predictive power compared with radial AIx@75 (AUC 0.54, P=0.01) and radial PP (AUC 0.52, P=0.006) but not for aortic PP (AUC 0.68, P=0.16).

Conclusion: Arterial stiffness assessed by the invasive catheter is associated with increasing risk for the adverse events. The central pulsatile parameter appeared to be a more efficient predictor than the peripheral arterial stiffness in patients without known artery heart disease.