Brachial-ankle pulse wave velocity is associated with coronary calcium in young and middle-aged asymptomatic adults: The Kangbuk Samsung Health Study

Cainzos-Achirica M 1 , Rampal S 2 , Chang Y 3 , Ryu S 3 , Zhang Y 4 , Zhao D 4 Show all authors , Cho J 5 , Choi Y 6 , Pastor-Barriuso R 7 , Lim SY 4 , Bruguera J 8 , Elosua R 8 , Lima JA 9 , Shin H 10 , Guallar E 11

Affiliations 

  • 1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Ciccarone Center for the Prevention of Heart Disease, Department of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
  • 2 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Social and Preventive Medicine, Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 3 Center for Cohort Studies, Total Healthcare Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
  • 4 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
  • 5 Center for Cohort Studies, Total Healthcare Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
  • 6 Center for Cohort Studies, Total Healthcare Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
  • 7 National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
  • 8 Division of Cardiology and Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
  • 9 Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
  • 10 Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea. Electronic address: hcfm.shin@samsung.com
  • 11 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA. Electronic address: eguallar@jhu.edu
Atherosclerosis, 2015 Aug;241(2):350-6.
PMID: 26071657 DOI: 10.1016/j.atherosclerosis.2015.05.031

Abstract

OBJECTIVE: To evaluate the association between brachial-ankle pulse wave velocity (baPWV), a convenient, non-radiating, readily available measurement of arterial stiffness, and coronary artery calcium (CAC), a reliable marker of coronary atherosclerosis, in a large sample of young and middle-aged asymptomatic adults; and to assess the incremental value of baPWV for detecting prevalent CAC beyond traditional risk factors.
METHODS: Cross-sectional study of 15,185 asymptomatic Korean adults who voluntarily underwent a comprehensive health screening program including measurement of baPWV and CAC. BaPWV was measured using an oscillometric method with cuffs placed on both arms and ankles. CAC burden was assessed using a multi-detector CT scan and scored following Agatston's method.
RESULTS: The prevalence of CAC > 0 and CAC > 100 increased across baPWV quintiles. The multivariable-adjusted odds ratios (95% CI) for CAC > 0 comparing baPWV quintiles 2-5 versus quintile 1 were 1.06 (0.87-1.30), 1.24 (1.02-1.50), 1.39 (1.15-1.69) and 1.60 (1.31-1.96), respectively (P trend < 0.001). Similarly, the relative prevalence ratios for CAC > 100 were 1.30 (0.74-2.26), 1.59 (0.93-2.71), 1.74 (1.03-2.94) and 2.59 (1.54-4.36), respectively (P trend < 0.001). For CAC > 100, the area under the ROC curve for baPWV alone was 0.71 (0.68-0.74), and the addition of baPWV to traditional risk factors significantly improved the discrimination and calibration of models for detecting prevalent CAC > 0 and CAC > 100.
CONCLUSIONS: BaPWV was independently associated with the presence and severity of CAC in a large sample of young and middle-aged asymptomatic adults. BaPWV may be a valuable tool for identifying apparently low-risk individuals with increased burden of coronary atherosclerosis.
KEYWORDS: Arterial stiffness; Atherosclerosis; Coronary artery calcium; Pulse wave velocity; Subclinical disease

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

MeSH terms
Similar publications