An increased peripheral arterial stiffness index was associated with an increased rate of major adverse cardiac events (MACEs), independent of age, coronary artery disease, and Rutherford category, according to the results of a study of patients with peripheral arterial disease (PAD) presenting to the vascular surgery outpatient clinic at the San Francisco Veterans Affairs Medical Center.

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Seventy-two patients with PAD were recruited during 2011-2016 and each had baseline radial artery applanation tonometry performed at a baseline visit. Their central radial artery augmentation index (AIX), normalized to 75 beats/min, and the peripheral AIX were calculated using pulse wave analysis. Subsequent MACEs were identified by chart review in the Journal of Surgical Research.

The cohort was predominately male (96%) and white (69%), with an average age of 69.4 years.

During a median follow-up period of 34 months, 14 patients experienced a MACE (19%). These events included eight myocardial infarctions or coronary revascularizations, four deaths from a cardiac cause, one stroke, and one transient ischemic attack. Unadjusted Cox proportional hazards models identified a significant association between the peripheral AIX and rate of MACE (hazard ratio, 1.54; 95% confidence interval, 1.06-2.22; P less than .02).

“These findings suggest that increased stiffness of the peripheral arteries may play a predictive role in patients with PAD. Furthermore, these findings inform future studies and suggest that the peripheral AIX may be used to risk stratify patients with PAD,” the researchers concluded.

The study was funded by public institutions including the National Institutes of Heath, the University of California, San Francisco, and a Society for Vascular Surgery Seed Grant and Career Development Award. The authors reported that they had no disclosures.

SOURCE: Ramirez JL et al. J Surg Res 2019;235:250-7.