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Published in: BMC Cardiovascular Disorders 1/2016

Open Access 01-12-2016 | Research article

Arterial stiffness in patients with coronary artery disease: relation with in-stent restenosis following percutaneous coronary intervention

Authors: Zrinko Prskalo, Ivica Brizić, Darko Markota, Ivica Markota, Mladen Boban, Monika Tomic, Boris Starcevic

Published in: BMC Cardiovascular Disorders | Issue 1/2016

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Abstract

Background

Coronary artery disease (CAD) is one of the most important issues in modern medicine due to its high mortality and prevalence. An early detection and prevention can reduce morbidity and mortality. Arterial stiffness is a potent and independent predictor of CAD. We aimed to investigate the arterial stiffness in CAD patients undergoing the coronary angiography. Also, we investigated a possible correlation between arterial stiffness and in-stent restenosis (ISR), an important limitation of percutaneous coronary intervention (PCI).

Methods

The study included 160 patients undergoing coronary angiography, treated either with PCI or with CABG. The pulse wave velocity (PWV) and augmentation index (AIx) were measured by the Arteriograph.

Results

PWV in the CAD group (12.24 ± 2.78 m/s) was significantly higher compared to the control group (8.27 ± 1.89 m/s). PWV in ISR and left main (LM) stenosis group (14.03 ± 3.15 and 13.89 ± 2.95 m/s) was significantly higher compared to the control and CAD groups. Peripheral and central AIx were significantly higher in CAD group (1.38 ± 30.63 % and 38.35 ± 15.52 %) than in control group (−11.35 ± 26.74 % and 26.91 ± 10.62 %). Patients with LM stenosis have significantly higher values of peripheral and central AIx (23.37 ± 23.77 % and 49.71 ± 12.02 %) than the CAD and ISR group.

Conclusions

The study confirmed a positive correlation between arterial stiffness measures, PWV and AIx, and CAD. Also, this study showed the correlation between PWV and ISR which can help to select more appropriate stent.
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Literature
1.
go back to reference Bonnefoy E, Kirkorian G. Mortality of myocardial infarction. Ann Cardiol Angeiol (Paris). 2011;60:311–6.CrossRef Bonnefoy E, Kirkorian G. Mortality of myocardial infarction. Ann Cardiol Angeiol (Paris). 2011;60:311–6.CrossRef
2.
go back to reference De Backer G, Ambrosioni E, Borch-Johnsen K, Brotons C, Cifkova R, Dallongeville J, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J. 2003;24:1601–10.CrossRefPubMed De Backer G, Ambrosioni E, Borch-Johnsen K, Brotons C, Cifkova R, Dallongeville J, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J. 2003;24:1601–10.CrossRefPubMed
4.
go back to reference Weber T, Auer J, O’Rourke MF, Kvas E, Lassnig E, Berent R, et al. Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation. 2004;109:184–9.CrossRefPubMed Weber T, Auer J, O’Rourke MF, Kvas E, Lassnig E, Berent R, et al. Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation. 2004;109:184–9.CrossRefPubMed
5.
go back to reference Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55:1318–27.CrossRefPubMed Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55:1318–27.CrossRefPubMed
6.
go back to reference Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001;37:1236–41.CrossRefPubMed Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001;37:1236–41.CrossRefPubMed
7.
go back to reference Gaszner B, Lenkey Z, Illyes M, Sarszegi Z, Horvath IG, Magyari B, et al. Comparison of aortic and carotid arterial stiffness parameters in patients with verified coronary artery disease. Clin Cardiol. 2012;35:26–31.CrossRefPubMed Gaszner B, Lenkey Z, Illyes M, Sarszegi Z, Horvath IG, Magyari B, et al. Comparison of aortic and carotid arterial stiffness parameters in patients with verified coronary artery disease. Clin Cardiol. 2012;35:26–31.CrossRefPubMed
8.
go back to reference Kim HJ, Nam JS, Park JS, Cho M, Kim CS, Ahn CW, et al. Usefulness of brachial-ankle pulse wave velocity as a predictive marker of multiple coronary artery occlusive disease in Korean type 2 diabetes patients. Diabetes Res Clin Pract. 2009;85:30–4.CrossRefPubMed Kim HJ, Nam JS, Park JS, Cho M, Kim CS, Ahn CW, et al. Usefulness of brachial-ankle pulse wave velocity as a predictive marker of multiple coronary artery occlusive disease in Korean type 2 diabetes patients. Diabetes Res Clin Pract. 2009;85:30–4.CrossRefPubMed
9.
go back to reference Morice MC, Serruys PW, Sousa JE, Fajadet J, Ban Hayashi E, Perin M, et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002;346:1773–80.CrossRefPubMed Morice MC, Serruys PW, Sousa JE, Fajadet J, Ban Hayashi E, Perin M, et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002;346:1773–80.CrossRefPubMed
10.
go back to reference Babapulle MN, Joseph L, Belisle P, Brophy JM, Eisenberg MJ. A hierarchical Bayesian meta-analysis of randomised clinical trials of drug-eluting stents. Lancet. 2004;364:583–91.CrossRefPubMed Babapulle MN, Joseph L, Belisle P, Brophy JM, Eisenberg MJ. A hierarchical Bayesian meta-analysis of randomised clinical trials of drug-eluting stents. Lancet. 2004;364:583–91.CrossRefPubMed
11.
go back to reference Cassese S, Byrne RA, Tada T, Pinieck S, Joner M, Ibrahim T, et al. Incidence and predictors of restenosis after coronary stenting in 10 004 patients with surveillance angiography. Heart. 2014;100:153–9.CrossRefPubMed Cassese S, Byrne RA, Tada T, Pinieck S, Joner M, Ibrahim T, et al. Incidence and predictors of restenosis after coronary stenting in 10 004 patients with surveillance angiography. Heart. 2014;100:153–9.CrossRefPubMed
12.
go back to reference Moses JW, Kipshidze N, Leon MB. Perspectives of drug-eluting stents: the next revolution. Am J Cardiovasc Drugs. 2002;2:163–72.CrossRefPubMed Moses JW, Kipshidze N, Leon MB. Perspectives of drug-eluting stents: the next revolution. Am J Cardiovasc Drugs. 2002;2:163–72.CrossRefPubMed
13.
go back to reference Milewski K, Zurakowski A, Pajak J, Pajak-Zielinska E, Liszka L, Buszman PP, et al. Comparison of thin-strut cobalt-chromium stents and stainless steel stents in a porcine model of neointimal hyperplasia. Med Sci Monit. 2010;16:40–4. Milewski K, Zurakowski A, Pajak J, Pajak-Zielinska E, Liszka L, Buszman PP, et al. Comparison of thin-strut cobalt-chromium stents and stainless steel stents in a porcine model of neointimal hyperplasia. Med Sci Monit. 2010;16:40–4.
14.
go back to reference Ueda H, Hayashi T, Tsumura K, Yoshimaru K, Nakayama Y, Yoshikawa J. The timing of the reflected wave in the ascending aortic pressure predicts restenosis after coronary stent placement. Hypertens Res. 2004;27:535–40.CrossRefPubMed Ueda H, Hayashi T, Tsumura K, Yoshimaru K, Nakayama Y, Yoshikawa J. The timing of the reflected wave in the ascending aortic pressure predicts restenosis after coronary stent placement. Hypertens Res. 2004;27:535–40.CrossRefPubMed
15.
go back to reference Nakayama Y, Tsumura K, Yamashita N, Yoshimaru K, Hayashi T. Pulsatility of ascending aortic pressure waveform is a powerful predictor of restenosis after percutaneous transluminal coronary angioplasty. Circulation. 2000;101:470–2.CrossRefPubMed Nakayama Y, Tsumura K, Yamashita N, Yoshimaru K, Hayashi T. Pulsatility of ascending aortic pressure waveform is a powerful predictor of restenosis after percutaneous transluminal coronary angioplasty. Circulation. 2000;101:470–2.CrossRefPubMed
16.
go back to reference Mahfouz RA, Abdulmoneim A, Abduo M, Elawady W. The relation of aortic stiffness and in-stent restenosis in patients undergoing percutaneous coronary stenting. Echocardiography. 2013;30:582–7.CrossRefPubMed Mahfouz RA, Abdulmoneim A, Abduo M, Elawady W. The relation of aortic stiffness and in-stent restenosis in patients undergoing percutaneous coronary stenting. Echocardiography. 2013;30:582–7.CrossRefPubMed
17.
go back to reference Fraker Jr TD, Fihn SD, Chronic Stable Angina Writing C, American College of C, American Heart A, Gibbons RJ, et al. 2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina. J Am Coll Cardiol. 2007;50:2264–74.CrossRefPubMed Fraker Jr TD, Fihn SD, Chronic Stable Angina Writing C, American College of C, American Heart A, Gibbons RJ, et al. 2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina. J Am Coll Cardiol. 2007;50:2264–74.CrossRefPubMed
18.
go back to reference Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention. 2005;1:219–27.PubMed Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention. 2005;1:219–27.PubMed
19.
go back to reference Baulmann J, Schillings U, Rickert S, Uen S, Dusing R, Illyes M, et al. A new oscillometric method for assessment of arterial stiffness: comparison with tonometric and piezo-electronic methods. J Hypertens. 2008;26:523–8.CrossRefPubMed Baulmann J, Schillings U, Rickert S, Uen S, Dusing R, Illyes M, et al. A new oscillometric method for assessment of arterial stiffness: comparison with tonometric and piezo-electronic methods. J Hypertens. 2008;26:523–8.CrossRefPubMed
20.
go back to reference Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hirayama Y, et al. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res. 2003;26:615–22.CrossRefPubMed Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hirayama Y, et al. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res. 2003;26:615–22.CrossRefPubMed
21.
go back to reference Liao J, Farmer J. Arterial stiffness as a risk factor for coronary artery disease. Curr Atheroscler Rep. 2014;16:387.CrossRefPubMed Liao J, Farmer J. Arterial stiffness as a risk factor for coronary artery disease. Curr Atheroscler Rep. 2014;16:387.CrossRefPubMed
22.
go back to reference Ede H, Erkoc MF, Okur A, Erbay AR. Impaired aortic elasticity and diastolic functions are associated with findings of coronary computed tomographic angiography. Med Sci Monit. 2014;20:2061–8.CrossRefPubMedPubMedCentral Ede H, Erkoc MF, Okur A, Erbay AR. Impaired aortic elasticity and diastolic functions are associated with findings of coronary computed tomographic angiography. Med Sci Monit. 2014;20:2061–8.CrossRefPubMedPubMedCentral
23.
go back to reference Liu CS, Li CI, Shih CM, Lin WY, Lin CH, Lai SW, et al. Arterial stiffness measured as pulse wave velocity is highly correlated with coronary atherosclerosis in asymptomatic patients. J Atheroscler Thromb. 2011;18:652–8.CrossRefPubMed Liu CS, Li CI, Shih CM, Lin WY, Lin CH, Lai SW, et al. Arterial stiffness measured as pulse wave velocity is highly correlated with coronary atherosclerosis in asymptomatic patients. J Atheroscler Thromb. 2011;18:652–8.CrossRefPubMed
24.
go back to reference Imanishi R, Seto S, Toda G, Yoshida M, Ohtsuru A, Koide Y, et al. High brachial-ankle pulse wave velocity is an independent predictor of the presence of coronary artery disease in men. Hypertens Res. 2004;27:71–8.CrossRefPubMed Imanishi R, Seto S, Toda G, Yoshida M, Ohtsuru A, Koide Y, et al. High brachial-ankle pulse wave velocity is an independent predictor of the presence of coronary artery disease in men. Hypertens Res. 2004;27:71–8.CrossRefPubMed
25.
go back to reference Cho SW, Kim BK, Kim JH, Byun YS, Goh CW, Rhee KJ, et al. Non-invasively measured aortic wave reflection and pulse pressure amplification are related to the severity of coronary artery disease. J Cardiol. 2013;62:131–7.CrossRefPubMed Cho SW, Kim BK, Kim JH, Byun YS, Goh CW, Rhee KJ, et al. Non-invasively measured aortic wave reflection and pulse pressure amplification are related to the severity of coronary artery disease. J Cardiol. 2013;62:131–7.CrossRefPubMed
26.
go back to reference Zieman SJ, Melenovsky V, Kass DA. Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vasc Biol. 2005;25:932–43.CrossRefPubMed Zieman SJ, Melenovsky V, Kass DA. Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vasc Biol. 2005;25:932–43.CrossRefPubMed
27.
go back to reference Strauss BH, Robinson R, Batchelor WB, Chisholm RJ, Ravi G, Natarajan MK, et al. In vivo collagen turnover following experimental balloon angioplasty injury and the role of matrix metalloproteinases. Circ Res. 1996;79:541–50.CrossRefPubMed Strauss BH, Robinson R, Batchelor WB, Chisholm RJ, Ravi G, Natarajan MK, et al. In vivo collagen turnover following experimental balloon angioplasty injury and the role of matrix metalloproteinases. Circ Res. 1996;79:541–50.CrossRefPubMed
28.
go back to reference Chung IM, Gold HK, Schwartz SM, Ikari Y, Reidy MA, Wight TN. Enhanced extracellular matrix accumulation in restenosis of coronary arteries after stent deployment. J Am Coll Cardiol. 2002;40:2072–81.CrossRefPubMed Chung IM, Gold HK, Schwartz SM, Ikari Y, Reidy MA, Wight TN. Enhanced extracellular matrix accumulation in restenosis of coronary arteries after stent deployment. J Am Coll Cardiol. 2002;40:2072–81.CrossRefPubMed
29.
go back to reference Osherov AB, Gotha L, Cheema AN, Qiang B, Strauss BH. Proteins mediating collagen biosynthesis and accumulation in arterial repair: novel targets for anti-restenosis therapy. Cardiovasc Res. 2011;91:16–26.CrossRefPubMed Osherov AB, Gotha L, Cheema AN, Qiang B, Strauss BH. Proteins mediating collagen biosynthesis and accumulation in arterial repair: novel targets for anti-restenosis therapy. Cardiovasc Res. 2011;91:16–26.CrossRefPubMed
30.
go back to reference Ueda H, Nakayama Y, Tsumura K, Yoshimaru K, Hayashi T, Yoshikawa J. Inflection point of ascending aortic waveform is a powerful predictor of restenosis after percutaneous transluminal coronary angioplasty. Am J Hypertens. 2002;15:823–6.CrossRefPubMed Ueda H, Nakayama Y, Tsumura K, Yoshimaru K, Hayashi T, Yoshikawa J. Inflection point of ascending aortic waveform is a powerful predictor of restenosis after percutaneous transluminal coronary angioplasty. Am J Hypertens. 2002;15:823–6.CrossRefPubMed
31.
go back to reference Farb A, Sangiorgi G, Carter AJ, Walley VM, Edwards WD, Schwartz RS, et al. Pathology of acute and chronic coronary stenting in humans. Circulation. 1999;99:44–52.CrossRefPubMed Farb A, Sangiorgi G, Carter AJ, Walley VM, Edwards WD, Schwartz RS, et al. Pathology of acute and chronic coronary stenting in humans. Circulation. 1999;99:44–52.CrossRefPubMed
32.
go back to reference Li C, Cantor WJ, Nili N, Robinson R, Fenkell L, Tran YL, et al. Arterial repair after stenting and the effects of GM6001, a matrix metalloproteinase inhibitor. J Am Coll Cardiol. 2002;39:1852–8.CrossRefPubMed Li C, Cantor WJ, Nili N, Robinson R, Fenkell L, Tran YL, et al. Arterial repair after stenting and the effects of GM6001, a matrix metalloproteinase inhibitor. J Am Coll Cardiol. 2002;39:1852–8.CrossRefPubMed
Metadata
Title
Arterial stiffness in patients with coronary artery disease: relation with in-stent restenosis following percutaneous coronary intervention
Authors
Zrinko Prskalo
Ivica Brizić
Darko Markota
Ivica Markota
Mladen Boban
Monika Tomic
Boris Starcevic
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2016
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-016-0305-4

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