Abstract 10329: Vascular Stiffness for Screening of Coronary Artery Disease in Asymptomatic Patients with Diabetes Mellitus
Introduction: Vascular stiffness is an early marker of coronary artery disease (CAD), and may potentially be used as a screening tool in asymptomatic patients with diabetes mellitus (DM). The purpose of this study was therefore to determine the association between vascular stiffness measured with pulse wave velocity (PWV) and augmentation index (AIx), and CAD assessed by myocardial perfusion imaging (MPI) in asymptomatic patients with DM.
Methods: Prospectively, 160 asymptomatic patients with DM (mean age 51 yrs, male 87) underwent MPI with adenosine stress. Summed stress score (SSS) was determined per patient according to a 17 segment and 5 point model. Abnormal MPI (SSS >3) was sub-classified as moderate (SSS 3–7) or severe (SSS ≥8) MPI defects. Using applanation tonometry, the carotid-femoral PWV and the radial AIx corrected to 75 beats per minute were determined non-invasively.
Results: MPI was abnormal in 61 patients (38%), with severe MPI defects in 22 patients (14%). Mean PWV increased from 8.4±2.2 m/s in patients with normal MPI to 9.0±2.2 m/s in patients with moderate MPI defects (P=0.11) and up to 11.1±2.5 m/s in patients with severe MPI defects (P<0.01). Likewise, mean AIx increased from 18.4±13.4% to 19.4±10.7% (P=0.66) between patients with normal MPI and moderate MPI defects and further increased to 25.4±9.0% in patients with severe MPI defects (P=0.03). After adjustment for age and other risk factors, PWV remained a significant predictor of severe MPI defects (P=0.01, OR 1.50, 95% CI 1.11–2.00), whereas AIx lost significance (P=0.20).
Conclusions: Vascular stiffness measured by PWV is strongly associated with severe MPI defects in asymptomatic patients with DM. Accordingly, PWV could be a useful screening tool to identify diabetic patients at higher risk for CAD.
- © 2010 by American Heart Association, Inc.