Association of Aortic Pulse Wave Velocity with the Severity of Coronary Artery Disease in Patients with Acute ST Elevation Myocardial Infarction

MA Razzaque, AAS Majumder, MT Rahman, AKMM Islam, M Ullah, MA Rahman, AR Khan, SMA Romel

Background: Arterial stiffness assessed noninvasively with aortic pulse wave velocity (PWV) has been
associated with atherosclerosis in the coronary arteries and also cardiovascular mortality. The aim of this
study was to evaluate the association between aortic PWV and severity of coronary artery disease (CAD) in
patients with acute ST elevation myocardial infarction (STEMI).
Methods: This cross sectional analytical study was conducted over 200 acute STEMI patients who were
purposively selected and agreed to do coronary angiogram during index hospital admission. Assessment
of aortic PWV was performed noninvasively with the commercially available SphygmoCor system using
applanation tonometry with high fidelity micromanometer on the day before angiogram. Study subjects
were subdivided into two groups on the basis of PWV. In group I: aortic PWV was d” 10 m/sec and in
group II: aortic PWV was> 10 m/sec. One hundred patients were included in each group. Angiographic
severity of CAD was assessed by vessel score, Friesinger score and Leaman score.
Results: Vessel score 0 and 1 were significantly higher in group I (p<0.05) where vessel score 2 and 3 were
significantly higher in group II (p<0.05).The mean PWV in the group with normal angiographic result was
8.10±2.9 m/sec, and in patients with single vessel disease it was 11.65±3.46m/sec. In those with double
and triple vessel disease the mean value of PWV was found 13.85±3.80 and 15.70±4.66 m/sec respectively.
The mean value of PWV increased in proportion with the number of vessel involved by CAD and the
differences were statistically significant(p=0.001).The mean value of PWV was observed 8.5±2.3 and
12.5±3.7m/sec in insignificant and significant CAD respectively using Friesinger score and the difference
was statistically significant (p<0.05).There was statistically significant positive linear relation between the
values of PWV and vessel score(r=.62, p=0.01), Friesinger score(r=.64, p=0.01) and Leaman score(r=.45,
Conclusion: Aortic PWV is associated with the extent and severity of CAD. This noninvasive, cheap,
radiation free method may be considered as risk stratification tool beyond other investigations.