P10 Combination of Flow-Mediated Dilation and Pulse Wave Velocity Provides Further Cardiovascular Risk Stratification in Patients with Coronary Artery Disease: Flow-Mediated Dilation Japan Study a (Fmd-J A)

Abstract

Purpose/Background/Objective

The usefulness of vascular function tests for management of patients with coronary artery disease (CAD) has not been fully investigated.

Methods

We measured flow-mediated vasodilation (FMD) and brachialankle pulse wave velocity (baPWV) in 462 patients with CAD for assessment of the predictive value of FMD and baPWV for cardiovascular events in a prospective multicenter observational study. The first primary outcome was coronary events, and the second primary outcome was a composite of coronary events, stroke, heart failure, and sudden death.

Results

A median follow-up period was 49.2 months. First primary outcome occurred in 56 patients and the second primary outcome occurred in 66 patients. FMD above the cutoff value of 7.1%, derived from receiver-operator curve analyses for the first and second primary outcomes, was significantly associated with lower risk of the first (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.06–0.74; P = 0.008) and second (HR, 0.32; 95% CI, 0.09–0.79; P = 0.01) primary outcomes. baPWV above the cutoff value of 1731 cm/s was significantly associated with higher risk of the first (HR, 1.86; 95% CI, 1.01–3.44; P = 0.04) and second (HR, 2.19; 95% CI, 1.23–3.90; P = 0.008) primary outcomes. Among the four groups stratified according to the combination of cutoff values of FMD and baPWV, stepwise increases in the calculated risk ratio for the first and second primary outcomes were observed.

Conclusions

Both FMD and baPWV were independent predictors of cardiovascular events in patients with CAD. The combination of FMD and baPWV provided further cardiovascular risk stratification.