Arterial stiffness contributes to coronary artery disease risk prediction beyond the traditional risk score (RAMA-EGAT score)

Heart Asia, 05/07/2012

Cardio–ankle vascular index (CAVI) is an independent risk predictor for coronary artery disease (CAD). The addition of CAVI to the RAMA–EGAT score significantly improves the diagnostic yield of CAD.

Methods

  • Cross–sectional study.
  • Patients with a moderate to high risk for CAD by the RAMA–EGAT score were enrolled between November 2005 and March 2006.
  • 64–slice multidetector CT coronary angiography was used to evaluate the coronary artery calcium score and coronary stenosis.
  • Arterial stiffness was assessed by CAVI.

Results

  • 1391 patients of median age 59 years (range 31–88) were enrolled in the study, 635 (45.7%) men and 756 (54.3%) women.
  • Of the 1391 patients, 346 (24.87%) had coronary stenosis.
  • There was a correlation between CAVI and the prevalence of coronary stenosis after adjusting for traditional CAD risk factors (OR 3.29).
  • In addition, adding CAVI into the RAMA–EGAT score (modified RAMA–EGAT score) improved the prediction of CAD incidence, increasing C–statistics from 0.72 to 0.85 and resulting in a net reclassification improvement of 27.7% (p<0.0001).

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