Increased arterial wave reflections predict severe cardiovascular events in patients undergoing percutaneous coronary interventions

Authors:
  • JAJohann Auer
    Johann Auer
  • MOMichael F. O'Rourke
    Michael F. O'Rourke
  • EKErich Kvas
    Erich Kvas
  • ELElisabeth Lassnig
    Elisabeth Lassnig
  • GLGudrun Lamm
    Gudrun Lamm
  • NSNina Stark
    Nina Stark
  • MRMartin Rammer
    Martin Rammer
  • BEBernd Eber
    Bernd Eber
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Abstract
Aims Increased arterial wave reflections are associated with the presence and extent of coronary atherosclerosis and with cardiovascular mortality in selected populations. We prospectively evaluated their prognostic value in the short- and long-term following percutaneous coronary interventions (PCIs). Methods and results We non-invasively quantified wave reflections [expressed as augmentation index corrected for heart rate of 75 b.p.m. (AIx@75)] using applanation tonometry of the radial artery and a validated transfer function to obtain the corresponding aortic values in 262 patients undergoing PCI. During 2-year follow-up, 61 patients reached the primary endpoint [death, myocardial infarction (MI), and restenosis]. Increasing tertiles of Alx@75 were related to the rate of patients reaching the primary endpoint [15.2, 20 and 35.3%, respectively (P=0.001)], as well as the secondary endpoints total mortality, myocardial infarction and death plus myocardial infarction (RR for the third vs. the first tertile 4.33, 3.25 and 3.46, respectively, PPConclusion Increased arterial wave reflections are independently associated with an increased risk for severe short- and long-term cardiovascular events in patients undergoing PCI.

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