Additional value of brachial-ankle pulse wave velocity to single-photon emission computed tomography in the diagnosis of coronary artery disease

Aim: the aim of this study was to investigate whether information on arterial stiffness can improve the value of single-photon emission computed tomography (spect) in the detection of obstructive coronary artery disease (cad). methods: a total of 233 patients (age: 62.2±10.8 years,60.3% males) with detected ischemia on spect undergoing invasive coronary angiography (ica) and brachial-ankle pulse wave velocity (bapwv) measurement within a month was retrospectively reviewed. results: of the 233 patients,190 (81.5%) had obstructive cad (≥50% luminal stenosis). the difference in bapwv according to the presence of obstructive cad was significant in patients in the mild ischemia group [summed stress score (sss): 4-8] (1,770±364 cm versus 1,490±328 cm,p<0.001) but not in the moderate (sss: 9-13) or severe (sss: ≥14) ischemia groups (p>0.05 for each). receiver operating characteristic curve analyses showed that the diagnostic value of bapwv for obstructive cad was significant only in patients in the mild ischemia group (area under curve: 0.714; p=0.001) but not in the moderate or severe ischemia groups (p>0.05 for each). adding information on bapwv to spect results and clinical parameters significantly increased diagnostic accuracy in the detection of obstructive cad in patients with mild ischemia (integrated discrimination improvement p=0.006) but not in those with moderate or severe ischemia on spect (p>0.05 for each). conclusions: the results of this study suggest that bapwv may have additional value to spect for the detection of obstructive cad,especially in patients with mild ischemia on spect. © japan atherosclerosis society.