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Aortic stiffness as a risk factor for recurrent acute coronary events in patients with ischaemic heart disease
Abstract
AIMS: Aortic elasticity is an important determinant of left ventricular performance and coronary blood flow. Moreover, it has been shown that aortic elastic properties deteriorate in patients with coronary artery disease. However, the predictive role of aortic elasticity in the occurrence of coronary events, has not been addressed so far. Therefore, we set out to test prospectively the hypothesis that invasive as well as non-invasive measures of aortic elastic properties, assessed at rest from pressure-diameter relationships, could predict the development of recurrent coronary events. METHODS AND RESULTS: Clinical variables and measures of aortic function were assessed in 54 normotensive patients with coronary artery disease. The aortic pressure-diameter relationship was derived invasively with a high-fidelity Y shaped catheter (developed in our Institution) for aortic diameter measurements, simultaneously with a Millar catheter for aortic pressure measurements. Aortic root distensibility was assessed by non-invasive techniques. During an average of 3 years follow-up, 12 of 54 patients either developed unstable angina (n=8) or acute myocardial infarction (n=4). By multivariate Cox model analysis, aortic stiffness was the strongest predictor of progression to any end-point (relative risk: 3.24, CI: 1.79 to 5.83;P=0.000). When aortic stiffness was not considered, aortic distensibility was the only independent predictor for acute coronary syndromes (relative risk: 0.37 CI: 0.21 to 0.65;P=0.000). CONCLUSION: In patients with coronary artery disease, aortic elastic properties are powerful and independent risk factors for recurrent acute coronary events.
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“Large-artery stiffness and wave reflections are important determinants of left ventricular (LV) function, coronary blood flow, and mechanical integrity of arteries and have been identified as markers of cardiovascular disease and independent prognosticators of cardiovascular risk (4 -12).”
From Smoking and caffeine have a synergistic detrimental effect on aortic stiffness and wave reflections (2004) · cites this paper as [9]
In the citing paper
“Large-artery stiffness and wave reflections are important determinants of left ventricular (LV) function, coronary blood flow, and mechanical integrity of arteries and have been identified as markers of cardiovascular disease and independent prognosticators of cardiovascular risk (4 -12).”
From Smoking and caffeine have a synergistic detrimental effect on aortic stiffness and wave reflections (2004) · cites this paper as [9]
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Correlation Between Arterial Stiffness and Plasma Endothelin-1 Concentration in Man with Obesity
Kosasih, A., Lilyasari, O., Gunawan, R. I., Haryono, N., & Sunu, I. (2013) · DOAJ (DOAJ: Directory of Open Access Journals) · doi:10.30701/ijc.v28i4.227
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Metadata
- Authors
- Stefanadis, C.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Stefanadis, C
- ORCID
- Stefanadis, C
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2000-03-01
- Volume
- 21
- Issue
- 5
- Pages
- 390-396
- ISSN
- 0195-668X (ISSN-L)
- OpenAlex
- W2151241107
- Cited by
- 217
- References
- 18
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 6 · 2020: 3 · 2019: 4 · 2018: 9 · 2017: 4 · 2016: 5 · 2015: 9 · 2014: 6 · 2013: 10 · 2012: 19
- FWCI
- 6.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Physical Sciences › Engineering › Biomedical Engineering › Elasticity and Material Modeling
- Keywords
- aortic stiffness, aortic elasticity, aortic distensibility, pressure-diameter relationship, coronary artery disease, acute coronary events, acute myocardial infarction, unstable angina, risk factors
- MeSH terms
- Aorta, Coronary Disease, Echocardiography, Elasticity, Female, Cardiac Catheterization, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Recurrence, Risk Factors, Proportional Hazards Models, Myocardial Ischemia, Risk Assessment
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