[Effect of arterial stiffness on development of cardio-vascular complications in ischemic heart disease].

With the aim to assess effect of arterial wall stiffness on prognosis of patients with stable form of ischemic heart disease (IHD) we included 224 men (mean age 56.2+/-8.9 years) with confirmed IND in a long-term prospective study. Pulse wave velocity was measured with brachial-ankle method (PWVba), presence of left ventricular hypertrophy (LVH) was detected with electrocardiography. Coronary arteriography was carried out in 126 patients. During 3.5 years of follow-up there were 38 cardiovascular complications (CVC) (6 myocardial infarctions, 19 operations of revascularization, 11 hospitalizations because of unstable angina, 3 sudden deaths). Patients were distributed to groups (tertiles) depending on PWVba values. Elevation of stiffness of arteries from lowest to highest tertile was significantly associated with increases of age, level of arterial pressure, heart rate, level of total cholesterol, LVH, severity and extent of coronary atherosclerosis. The Cox model of proportional risks comprising 14 main risk factors allowed to reveal that only PWVba significantly (<0.001) contributed to formation of prognosis. In patients with PWVba exceeding 14.3 m/s (highest tertile) compared with those with PWVba below 12.4 m/s (lowest tertile) risk of development of CVC was 4.23 times higher (5.27 times higher after adjustment for age and systolic arterial pressure). Comparison of Kaplan-Maier survival curves confirmed that in patients with low PWVba cumulative probability of absence of CVC was greater than in patients with higher stiffness of arterial wall (<0.008). PWVba as marker of arterial stiffness in men with chronic course of IHD appears to be predictor of CVC independent on age and classic risk factors.