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Abstract: P339 PERIPHERAL AUGMENTATION INDEX: A NOVEL NON-INVASIVE MARKER OF CORONARY ARTERY DISEASE
Poster - EPIDEMIOLOGY OF CVD - Global Risk Assessment Abstract: P339 Citation: Atherosclerosis Supplement 2009, Vol. 10, Issue 2
PERIPHERAL AUGMENTATION INDEX: A NOVEL NON-INVASIVE MARKER OF CORONARY ARTERY DISEASE E Patvardhan, K Heffernan, R Karas, J Kuvin Cardiology, Tufts Medical Center, Boston, MA Objectives: Augmentation Index (AIx) measures the contribution that wave reflection makes to the arterial pressure waveform and reflects systemic arterial stiffness. AIx derived from the aorta has been shown to predict the presence of coronary artery disease (CAD). Peripheral arterial tonometry (PAT) is a non-invasive vascular tool that provides a measure of AIx obtained from pulse wave amplitude. The purpose of this study was to examine the relationship between peripherally measured AIx and CAD. Methods: PAT (Itamar Medical, Israel) was performed on stable patients in a controlled environment. The PAT probe was placed on the second finger and continuous diastolic pressure was applied to obtain pulse amplitude. AIx was calculated as the ratio of amplitude of the pressure wave above its systolic shoulder relative to pulse pressure. CAD+ was defined as the presence of ischemia or infarction on SPECT imaging or epicardial coronary artery stenosis >50% by angiography. Results: 152 patients participated (77 CAD+). CAD+ patients had significantly higher AIx compared to CAD- (-4.9±1.8 (SE) vs. -13.8±1.8 %, p<0.05). According to binary logistic regression, after adjusting for potential confounders, including age, sex, smoking, diabetes, hypertension and hypercholesterolemia, patients in the highest tertile of AIx were 4.4 times more likely to be CAD+ compared with patients in the lowest tertile (95% C.I. 1.4-13.6, p<0.05). Area under the ROC curve was 0.62 (p<0.05). Conclusion: PAT-derived AIx is a significant predictor of CAD and may be useful as a noninvasive tool in the clinical assessment of atherosclerosis. Large-scale studies focusing on AIx and its prognostic value are needed. Funding: Itamar Medical.
PERIPHERAL AUGMENTATION INDEX: A NOVEL NON-INVASIVE MARKER OF CORONARY ARTERY DISEASE E Patvardhan, K Heffernan, R Karas, J Kuvin Cardiology, Tufts Medical Center, Boston, MA Objectives: Augmentation Index (AIx) measures the contribution that wave reflection makes to the arterial pressure waveform and reflects systemic arterial stiffness. AIx derived from the aorta has been shown to predict the presence of coronary artery disease (CAD). Peripheral arterial tonometry (PAT) is a non-invasive vascular tool that provides a measure of AIx obtained from pulse wave amplitude. The purpose of this study was to examine the relationship between peripherally measured AIx and CAD. Methods: PAT (Itamar Medical, Israel) was performed on stable patients in a controlled environment. The PAT probe was placed on the second finger and continuous diastolic pressure was applied to obtain pulse amplitude. AIx was calculated as the ratio of amplitude of the pressure wave above its systolic shoulder relative to pulse pressure. CAD+ was defined as the presence of ischemia or infarction on SPECT imaging or epicardial coronary artery stenosis >50% by angiography. Results: 152 patients participated (77 CAD+). CAD+ patients had significantly higher AIx compared to CAD- (-4.9±1.8 (SE) vs. -13.8±1.8 %, p<0.05). According to binary logistic regression, after adjusting for potential confounders, including age, sex, smoking, diabetes, hypertension and hypercholesterolemia, patients in the highest tertile of AIx were 4.4 times more likely to be CAD+ compared with patients in the lowest tertile (95% C.I. 1.4-13.6, p<0.05). Area under the ROC curve was 0.62 (p<0.05). Conclusion: PAT-derived AIx is a significant predictor of CAD and may be useful as a noninvasive tool in the clinical assessment of atherosclerosis. Large-scale studies focusing on AIx and its prognostic value are needed. Funding: Itamar Medical.