Arterial stiffness contributes to coronary artery disease risk prediction beyond the traditional risk score (RAMA-EGAT score) Heart Asia, 05/07/2012

Yingchoncharoen T et al. – 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.

• 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.

• 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).