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A8200 Clinical Significance and Determinants of Arterial Stiffness in Male Patients with Premature Coronary Artery Disease

Objectives: Increased arterial stiffness has been an independent predictor for cardiovascular events. We aimed to study the clinical significance of arterial stiffness assessed by brachial-ankle pulse-wave velocity (baPWV) in patients with premature coronary artery disease (CAD) and evaluated the determinants of arterial stiffness. Methods: We consecutively collected 140 male patients aged ⩽45 years admitted with coronary artery disease in our hospital. All patients had angiographic evidence of a flow limiting stenosis of >50% diameter in at least one major coronary artery. Patients with acute coronary syndrome, acute heart failure, infection disease and liver dysfunction were excluded. baPWV was measured by a validated oscillometric device(BP-203RPE III [VP-1000],Omron, Japan). baPWV ≥1400 cm/s was defined as arterial stiffness. Results: Forty-seven (33.6%) patients had arterial stiffness and had higher percentages of hypertension (P = 0.027), higher concentration of lipoprotein(a)(P = 0.047), and more coronary artery involvement (P = 0.009) compared with patients without arterial stiffness. Multivariate regression analysis showed that age, especially age onset ⩽40 years (OR:0.250,95%CI:0.088–0.709,P = 0.09), multi-vessel involvement (OR:2.430,95%CI:1.303–4.533,P = 0.005), diastolic blood pressure (DBP)(OR:1.192,95%CI:1.079–1.315,P = 0.001), and serum lipoprotein (a)(OR:1.002,95%CI:1.001–1.003,P = 0.037) were independent predictors of arterial stiffness in male patients with premature CAD. Conclusion: Patients with arterial stiffness had more risk factors for atherosclerosis and CAD severity. A younger age onset, more coronary artery involvement, DBP, serum lipoprotein (a) were determinants of arterial stiffness in male patients with premature CAD.