The Research Of The Relativity Of Brachial-ankle-artery Pulse Wave Velocity And Risk Factors In The Coronary Artery Disease

Objective:To explore the common risk factors of the brachial-ankle-artery (baPWV) abnormalities and coronary artery disease (CAD), and the relativity of them. The comparison of the clinical value of two diagnostic criteria of baPWV in the CAD patients. Analyzing the projection of CAD which caused by abnormally baPWV. Providing the evidence for the prevention and realize of the CAD.Methods:Collective 175 patients who might have been diagnosed as CAD, had coronary angiography (CAG) and also examined with baPWV in November 2008-2009 years in November at the First Affiliated Hospital of Kunming Medical College of Cardiology. Among them,145 cases of male and 30 female aged 32～83 (60.57±11.09) years old. Clinical data and Laboratory data collected. Measuring ABI, baPWV values, calculated body mass index (BMI), recorded coronary angiography results. At frist, as the coronary angiography, patients are classified into CAG normal group (25 cases) and the CAG abnormal group (150 cases). Group baPWV as normal and abnormal based the age corrected normal values for the standard, namely baPWV1. baPWV1 divided into normal group (107 cases) and abnormal (68 cases). baPWV±1400cm/s for the normal standard, namely baPWV2. baPWV2 divided into normal group (61 cases) and abnormal group (114 cases). Using statistical analysis of various risk factors in whether there are significant differences between the two groups. CAD was divided into coronary atherosclerosis(CAS) group (22 cases), one branch process group (57cases),two branch process group (39cases),multi-branch process group (32cases), with statistical analysis are compared between the two of the four groups of risk factors and whether there are significant differences. Analyse the relativity of risk factors and CAG group, baPWV group with univariate linear correlation.The relevant risk factors are the independent variables and CAG group, baPWV group are the dependent variable for multiple linear regression analysis. baPWV predicted the final calculation of the CAD sensitivity, specificity, correct index, positive predictive value and negative predictive value.Results:The risk factors of abnormal group; age, BMI, TC, LDL, UAwere higher than normal group and abnormal group the proportion of male control group, history of hypertension was significantly higher than normal group (P<0.05). The risk factors of baPWV1 abnormal group; the proportion of the hypertension history and diabetes mellitus was higher than normal group (P<0.05). The risk factors of baPWV2 abnormal group; Abnormal group patients are older, history of hypertension in patients higher than normal group (P<0.05).CAG abnormal risk factors between any two. TC, LDL, history of hypertension were significantly different between groups (P<0.05). Risk factors and CAG group univariate linear correlation analysis. Age, LDL, UA, baPWV, history of hypertension was positively correlated with CAG group. HDL, ABI, gender and CAG group were negatively correlated (P<0.05). Risk factors and baPWV1 group, baPWV2 group univariate linear correlation analysis. History of hypertension, diabetes mellitus positively related to baPWV1 group. History of hypertension and age are positively related to baPWV2 group (P<0.05). Risk factors and CAG group multiple linear regression analysis. LDL, sex, history of hypertension and age are independent risk factors for CAD (P<0.05). Risk factors and baPWV1 group, baPWV2 group multiple linear regression analysis. History of hypertension, diabetes mellitus is an independent risk factor for abnormal baPWV1. And age, history of hypertension are independent risk factors for abnormal baPWV2 (P<0.05). baPWV1 and baPWV2 against CAD predictions. baPWV1 specificity of the CAD predictions, forecast to reach 56%; while baPWV2 sensitivity of the CAD predictions, forecast to reach 67%. baPWV1 and baPWV2 right index were-0.06 and 0.11. baPWV2positive predictive value was higher than baPWV1,88%; negative predictive value is also higher than baPWV1,18%.Conclusions:Age and history of hypertension is a common independent risk factors for CAD and abnormal baPWV. After correction for age, diabetes mellitus is a independent risk for abnormal baPWV. baPWV and CAD have some relevance. However, baPWV has no relevance to the severity of pathological changes of CAD. baPWV has some predictive value.≤1400cm/s for the normal standard of baPWV predicted CAD after correction for age, baPWV than the lower specificity, but the overall accuracy of better forecasts.