Prognostic Value of Brachial-ankle Pulse Wave Velocity in Patients with Non-ST-elevation Myocardial Infarction

Objective: Brachial-ankle pulse wave velocity (baPWV) measurement is a well-established modality for assessing arterial stiffness and predicting cardiovascular events. However, to our knowledge, its usefulness has not been clarified among patients with non-ST-elevation myocardial infarction (NSTEMI). This study assessed the prognostic value of baPWV in patients with NSTEMI.

Patients And Methods: Patients (n=411, mean age, 63.8±13.5 years, 75.2% men) with NSTEMI who underwent a percutaneous coronary intervention and baPWV measurement were recruited between January 2013 and December 2015. Cardiac mortality and major adverse cardiovascular events (MACE) including cardiac death, re-acute myocardial infarction, revascularization, heart failure, and stroke after discharge were analyzed. The mean follow-up duration was 350 days.

Results: MACE and cardiac mortality occurred in 26 (6.3%) patients and 13 (3.1%) patients. Kaplan-Meier survival curves showed that MACE and cardiac mortality were significantly higher in patients with high baPWV (1708.0 cm/s). In multivariable Cox regression analysis, high baPWV (hazard ratio: 2.55; 95% confidence interval: 1.03-6.30, P=0.043) was an independent predictor of MACE even after adjusting for possible confounders.

Conclusion: Our findings indicate that baPWV was a strong independent prognostic factor of MACE in patients with NSTEMI. This suggests that baPWV can be a useful prognostic factor in the clinical setting for easier and less invasive prediction of MACE in patients with NSTEMI.